NPIMap

Organization Active NPI

Madugula PLLC

  • Dentist
  • Longview, WA
National Provider Identifier
1285978189
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
272750 Issued in WA
Legal business name
MADUGULA PLLC
Practice address
740 Ocean Beach Hwy Ste F
Longview, WA 98632-4061
Phone
(360) 414-1400
Fax
(360) 414-5223
NPI assigned
Nov 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kala Madugula, DMD
Title
Owner
Phone
(315) 454-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 272750 WA Primary

Addresses

Primary practice location

740 Ocean Beach Hwy Ste F
Longview, WA 98632-4061

Mailing address

PO Box 3189
Syracuse, NY 13220-3189
Phone (315) 454-6000

Other names 1

  • Aspen Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1285978189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189",
            "telephone_number": "315-454-6000",
            "fax_number": "866-803-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 OCEAN BEACH HWY STE F",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324061",
            "telephone_number": "360-414-1400",
            "fax_number": "360-414-5223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADUGULA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "MADUGULA",
        "authorized_official_first_name": "KALA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-454-6000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "272750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspen Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Longview, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.