Active NPI
Kishore Babu Thammineni, DDS
- Dentist
- Alexandria, VA
National Provider Identifier
1326326620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401414079
- Practice address
- 3479 N Beauregard St
Alexandria, VA 22302-1341 - Phone
- (571) 814-3389
- Fax
- (571) 814-3390
- NPI assigned
- Aug 3, 2011
- Last updated
- Aug 30, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 0401414079 | VA | Primary |
Addresses
Primary practice location
3479 N Beauregard St
Alexandria, VA 22302-1341
Mailing address
3479 N Beauregard St
Alexandria, VA 22302-1341
Phone (571) 814-3389
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401414079 | VA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Services Inc | Past | Accepting new patients | |
| Modern Dental Professionals MN PC | Past | Accepting new patients | |
| Dental Professionals of Virginia, P.C. | Dentist | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724976000000",
"number": "1326326620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3479 N BEAUREGARD ST",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223021341",
"telephone_number": "571-814-3389",
"fax_number": "571-814-3390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3479 N BEAUREGARD ST",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223021341",
"telephone_number": "571-814-3389",
"fax_number": "571-814-3390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAMMINENI",
"first_name": "KISHORE BABU",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-08-03",
"last_updated": "2024-08-30",
"certification_date": "2024-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401414079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.