Sakthi Samyuktha Prabakaran, BDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 20397 Issued in FL

Practice address

2702 W Hillsborough Ave
Tampa, FL 33614-6053

Phone

(813) 365-3021

NPI assigned

Aug 29, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389225600000",
    "number": "1316296916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12814 SADDLE CLUB CIR APT 304",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336359654",
            "telephone_number": "509-731-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 W HILLSBOROUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336146053",
            "telephone_number": "813-365-3021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRABAKARAN",
        "first_name": "SAKTHI",
        "middle_name": "SAMYUKTHA",
        "name_prefix": "Dr.",
        "credential": "BDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2014-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60161954",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 20397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Wilson Poynter, MD
• Leticia Pozas Jimenez
• PP-FL LLC
• PPR&D Biomarkers Inc,
• Sabrina Prabakaran
• Arthi Prabhakar
• Gayle Cordelia Prabhakaran
• John Desaraj Prabhakarian
• Practical Rehab LLC
• Stefan A Prada, MD

• General Practice Dentistry in Tampa, FL
• Providers in Tampa, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2014; 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.

Verify at the official NPI Registry.