Dr. Surender Tippireddy DMD LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30023515 Issued in OH

Legal business name

DR. SURENDER TIPPIREDDY DMD LLC

Practice address

440 Beecher Rd
Gahanna, OH 43230-1797

Phone

(614) 855-5828

Fax

(614) 855-5827

NPI assigned

Apr 12, 2017

Organization subpart

No

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

Authorized official

Name

Surender Tippireddy, DMD

Title

General Dentist

Phone

(614) 855-5828

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dale R. Theis, D.D.S

  • Dentist
  • Gahanna, OH
  • NPI 1215010780
  NPD (past)

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491955200000",
    "number": "1356875868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 BEECHER RD",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432301797",
            "telephone_number": "614-855-5828",
            "fax_number": "614-855-5827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 BEECHER RD",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432301797",
            "telephone_number": "614-855-5828",
            "fax_number": "614-855-5827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. SURENDER TIPPIREDDY DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-12",
        "last_updated": "2017-04-12",
        "status": "A",
        "authorized_official_last_name": "TIPPIREDDY",
        "authorized_official_first_name": "SURENDER",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "614-855-5828",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30023515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0089122",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mortimer Dolman, M.D.
• Lorna F Donovan, M.D.
• Dana Lee Douglas
• Dr Michael Drown PHD General & Consulting Psychology
• Dr. Jackie Berkowitz
• Kathryn Dragt, DPT
• Timothy P Drankwalter, D.O.
• Annmarie Driscoll
• Michael Glenn Drown, PH.D., PSYCHOLOGIST
• DRS. Bacon & Hooper, Inc.

• General Practice Dentistry in Gahanna, OH
• Providers in Gahanna, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; 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.