Active NPI
Vinutha Kupperi
- General Practice Dentistry
- Marvin, NC
National Provider Identifier
1346529807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 10597
- Practice address
- 1309 Firethorne Club Dr
Marvin, NC 28173-6562 - Phone
- (704) 499-7153
- NPI assigned
- Aug 15, 2011
- Last updated
- Dec 13, 2023
- 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 | 10597 | NC | Primary |
Addresses
Primary practice location
1309 Firethorne Club Dr
Marvin, NC 28173-6562
Mailing address
4509 Carrie Ann Lane
Abilene, TX 79606
Phone (310) 721-5793
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- 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 |
|---|---|---|---|---|
| I20240501003657 | NC | Order and Referring Only - Dentist | 6800236241 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10597 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702425600000",
"number": "1346529807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4509 CARRIE ANN LANE",
"city": "ABILENE",
"state": "TX",
"postal_code": "79606",
"telephone_number": "310-721-5793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1309 FIRETHORNE CLUB DR",
"city": "MARVIN",
"state": "NC",
"postal_code": "281736562",
"telephone_number": "704-499-7153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUPPERI",
"first_name": "VINUTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-15",
"last_updated": "2023-12-13",
"certification_date": "2023-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "10597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marvin, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; 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.