Individual provider Active NPI

Naga Sai Pranathi Gundimeda, DMD

  • Dentist
  • Herndon, VA
National Provider Identifier
1376422816
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401419659 Issued in VA
Practice address
2390 Stone Fence LN
Herndon, VA 20171-5367
Phone
(571) 524-7818
NPI assigned
Aug 28, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401419659 VA Primary

Addresses

Primary practice location

2390 Stone Fence LN
Herndon, VA 20171-5367

Mailing address

2390 Stone Fence LN
Herndon, VA 20171-5367
Phone (571) 524-7818

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
0401419659VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1756339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1376422816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2390 STONE FENCE LN",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201715367",
            "telephone_number": "571-524-7818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2390 STONE FENCE LN",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201715367",
            "telephone_number": "571-524-7818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDIMEDA",
        "first_name": "NAGA SAI PRANATHI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-28",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401419659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; 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.