Active NPI
Rajitha Dhanekula
- General Practice Dentistry
- Midland, TX
National Provider Identifier
1356998702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 39074
- Practice address
- 1000 N Midkiff Rd
Midland, TX 79701-2101 - Phone
- (432) 348-4438
- NPI assigned
- Aug 21, 2019
- Last updated
- Oct 10, 2022
- 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 | 39074 | TX | Primary |
Addresses
Primary practice location
1000 N Midkiff Rd
Midland, TX 79701-2101
Mailing address
1000 N Midkiff Rd
Midland, TX 79701-2101
Phone (432) 348-4438
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- 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 |
|---|---|---|---|---|
| I20190918002641 | CT | Order and Referring Only - Dentist | 8921338906 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39074 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665360000000",
"number": "1356998702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 N MIDKIFF RD",
"city": "MIDLAND",
"state": "TX",
"postal_code": "797012101",
"telephone_number": "432-348-4438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 N MIDKIFF RD",
"city": "MIDLAND",
"state": "TX",
"postal_code": "797012101",
"telephone_number": "432-348-4438"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DHANEKULA",
"first_name": "RAJITHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-21",
"last_updated": "2022-10-10",
"certification_date": "2022-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "39074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; 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.