Individual provider Active NPI

Indra Ramasubbu, DMD

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1346574878
Registry record updated Sep 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
054672-1 Issued in NY
Practice address
1212 Kings Hwy
Brooklyn, NY 11229-1002
Phone
(718) 376-6700
NPI assigned
Sep 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 054672-1 NY Primary

Addresses

Primary practice location

1212 Kings Hwy
Brooklyn, NY 11229-1002

Mailing address

1384 E 70TH St
Brooklyn, NY 11234-5704
Phone (718) 820-2570

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
054672-1NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1254268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254268800000",
    "number": "1346574878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1384 E 70TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345704",
            "telephone_number": "718-820-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291002",
            "telephone_number": "718-376-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMASUBBU",
        "first_name": "INDRA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-30",
        "last_updated": "2009-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "054672-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2009; 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.