Active NPI
Uma Deepthi Potluri
- Dentist
- Fort Worth, TX
National Provider Identifier
1366086589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 35793
- Practice address
- 4200 South Fwy
Fort Worth, TX 76115-1400 - Phone
- (682) 747-0001
- NPI assigned
- Oct 31, 2019
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 35793 | TX | Primary |
Addresses
Primary practice location
4200 South Fwy
Fort Worth, TX 76115-1400
Mailing address
2803 Riverside Pkwy Apt 2208
Grand Prairie, TX 75050-8741
Phone (314) 269-0871
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
| License | State | Type | Specialty |
|---|---|---|---|
| 35793 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572480000000",
"number": "1366086589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2803 RIVERSIDE PKWY APT 2208",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750508741",
"telephone_number": "314-269-0871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4200 SOUTH FWY",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761151400",
"telephone_number": "682-747-0001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTLURI",
"first_name": "UMA",
"middle_name": "DEEPTHI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-31",
"last_updated": "2019-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "35793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.