Guru Datta PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

GURU DATTA PLLC

Doing business as

Smile N Shine Dental

Practice address

6500 Denton Hwy Ste B1
Watauga, TX 76148-2526

Phone

(817) 428-4005

NPI assigned

Sep 25, 2023

Last updated

Oct 15, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Manjusha Tummala, DDSNPI 1679704076

Title

General Dentist

Phone

(848) 391-6885

Specialties & licenses 1

Addresses

Other names 1

• Smile N Shine Dental Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Manjusha Tummala, DDS

  • General Practice Dentistry
  • Watauga, TX
  • NPI 1679704076
  NPD Authorized official
• John Jong Lee, DDS

  • Dentist
  • Watauga, TX
  • NPI 1023222767
  NPD
• Richard Wayne Townsley II

  • Dentist
  • Watauga, TX
  • NPI 1578735353
  NPD (past)

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697328000000",
    "number": "1295514651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 BANBURY RD",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750192063",
            "telephone_number": "848-391-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 DENTON HWY STE B1",
            "city": "WATAUGA",
            "state": "TX",
            "postal_code": "761482526",
            "telephone_number": "817-428-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GURU DATTA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-10-15",
        "certification_date": "2023-10-15",
        "status": "A",
        "authorized_official_last_name": "TUMMALA",
        "authorized_official_first_name": "MANJUSHA",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "848-391-6885",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile N Shine Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Felisa Gallosa Rivero
• Ashly Harris, RN
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• Dentist in Watauga, TX
• Providers in Watauga, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2023; 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.