Banuru Shetty Dental Group, P.L.L.C

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BANURU SHETTY DENTAL GROUP, P.L.L.C

Practice address

7727 Flying Cloud Dr
Eden Prairie, MN 55344-3708

Phone

(201) 336-0434

NPI assigned

Aug 8, 2024

Organization subpart

No

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

Authorized official

Name

Vasudha Banuru, DDSNPI 1588071781

Title

Dentist

Phone

(201) 336-0434

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Vasudha Banuru, DDS

  • Dentist
  • Savage, MN
  • NPI 1588071781
  NPD Authorized official

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

{
    "created_epoch": "1723075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723075200000",
    "number": "1295566628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7727 FLYING CLOUD DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443708",
            "telephone_number": "201-336-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7727 FLYING CLOUD DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443708",
            "telephone_number": "201-336-0434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANURU SHETTY DENTAL GROUP, P.L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-08",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-07",
        "status": "A",
        "authorized_official_last_name": "BANURU",
        "authorized_official_first_name": "VASUDHA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "201-336-0434",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Baillargeon, M.D.
• Katherine Baillon, DO, MPH
• Wendy Joan Baker, LMFT
• Veronica Balderas
• Talha John Baloch, MD
• Amber Linnae Banwart, ATC, PTA
• Jessica Lynn Barclay
• Lindsay Barganz-Junker, MA, LMFT
• Nancy Gail Barnd
• Jerod Adam Barnes, PA

• All providers in Eden Prairie, MN
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; 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.