Susee Priyanka Ravuri, BDS, MPA, MSD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60729800 Issued in WA

Practice address

1002 N Meridian Ste A104
Puyallup, WA 98371-4409

Phone

(619) 300-9832

NPI assigned

May 23, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1376990077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 N MERIDIAN STE A104",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983714409",
            "telephone_number": "619-300-9832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 N MERIDIAN STE A104",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983714409",
            "telephone_number": "619-300-9832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2165 Cunningham Dr",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "VA",
            "postal_code": "236662569",
            "country_code": "US",
            "telephone_number": "619-300-9832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAVURI",
        "first_name": "SUSEE PRIYANKA",
        "name_prefix": "Miss",
        "credential": "BDS, MPA, MSD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-23",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401415871",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60729800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Rausch
• Christal Marie Rausch
• Michael W Rausch, MD
• Roshnee Girish Raval, OD
• Shalini Ravi Kumar, MD
• Alexandria Ray
• Christina Irene Ray, PA-C
• Kierstyn Ray, PT, DPT
• Malena Catherine Ellen Ray, M.ED, LCMHCA
• Marcus Alan Ray

• General Practice Dentistry in Puyallup, WA
• Providers in Puyallup, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; 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.