Active NPI
Sujatha Vemuri, DDS
- General Practice Dentistry
- Washington, DC
National Provider Identifier
1306909866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DEN1000463
- Practice address
- 3925 Minnesota Ave NE
Washington, DC 20019-2662 - Phone
- (703) 347-4577
- NPI assigned
- Dec 18, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DEN1000463 | DC | Primary |
Addresses
Primary practice location
3925 Minnesota Ave NE
Washington, DC 20019-2662
Mailing address
350 N Clark St, Ste 600
C/O Kos Services
Chicago, IL 60654
Phone (703) 347-4577
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 024905300 | Medicaid | DC | |
| 11640775 | Other | CAQH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170119000912 | DC | Order and Referring Only - Dentist | 6002198488 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN1000463 | DC | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380153600000",
"number": "1306909866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 N CLARK ST, STE 600",
"address_2": "C/O KOS SERVICES",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60654",
"telephone_number": "703-347-4577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3925 MINNESOTA AVE NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200192662",
"telephone_number": "703-347-4577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VEMURI",
"first_name": "SUJATHA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-18",
"last_updated": "2013-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "DC",
"license": "DEN1000463",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "024905300",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11640775",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.