Individual provider Active NPI

Chiranjeevi Tummala, D.D.S

  • Dentist
  • Houston, TX
National Provider Identifier
1336318658
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0022894 Issued in TX
Practice address
5411 S Braeswood Blvd
Houston, TX 77096-4001
Phone
(713) 723-7200
NPI assigned
Feb 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 38846 TX
Dentist 122300000X 0022894 TX Primary

Addresses

Primary practice location

5411 S Braeswood Blvd
Houston, TX 77096-4001

Mailing address

3027 Conway St
Houston, TX 77025-2609
Phone (713) 667-6151

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

LicenseStateTypeSpecialty
0022894TXMDDentist
38846TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Dentist PC Past Accepting new patients
Meyerland Family Dentistry PC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1336318658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3027 CONWAY ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770252609",
            "telephone_number": "713-667-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5411 S BRAESWOOD BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770964001",
            "telephone_number": "713-723-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUMMALA",
        "first_name": "CHIRANJEEVI",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-21",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "38846",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "0022894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; 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.