Sowmya Kanumilli, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401412699 Issued in VA

Practice address

24600 Millstream Dr Ste 470
Aldie, VA 20105-5686

Phone

(703) 327-9222

Fax

(703) 327-9211

NPI assigned

Jun 25, 2009

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1346478575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24600 MILLSTREAM DR STE 470",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "201055686",
            "telephone_number": "703-327-9222",
            "fax_number": "703-327-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24600 MILLSTREAM DR STE 470",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "201055686",
            "telephone_number": "703-327-9222",
            "fax_number": "703-327-9211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANUMILLI",
        "first_name": "SOWMYA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1855182",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401412699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Aldie, VA
• Providers in Aldie, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; 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.