Active NPI
Padma Daggula
- Pediatric Dentistry
- Longview, TX
National Provider Identifier
1275814212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 27427
- Practice address
- 2539 Judson Rd
Longview, TX 75605-4643 - Phone
- (903) 553-1586
- Fax
- (903) 234-8169
- NPI assigned
- Sep 5, 2011
- Last updated
- Sep 26, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 59728 | CA | |
| Pediatric Dentistry | 1223P0221X | 27427 | TX | Primary |
| General Practice Dentistry | 1223G0001X | 27427 | TX |
Addresses
Primary practice location
2539 Judson Rd
Longview, TX 75605-4643
Mailing address
2539 Judson Rd
Longview, TX 75605-4643
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27427 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316995200000",
"number": "1275814212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2539 JUDSON RD",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756054643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2539 JUDSON RD",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756054643",
"telephone_number": "903-553-1586",
"fax_number": "903-234-8169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAGGULA",
"first_name": "PADMA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-05",
"last_updated": "2011-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "59728",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "27427",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "27427",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longview, TX
- John T D'Antoni, MD
- D&S Residential Services, LP (Chad Community Home)
- D&S Residential Services, LP (Honeysuckle Community Home)
- D&S Residential Services, LP (Thelma Community Home)
- Dexter Berlin Dafney, DDS
- Ranjan Dahal, MD
- Charles Glenn Dailey Jr., LCSW
- Douglas James Daly Jr., D.C.
- Daniel David Dan, PHARM.D.
- Daniel & Max, LLC (Stanton Optical)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.