Deepthi Mundra, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6907-15 Issued in WI

Practice address

Smile Care, PLLC
1237 Highway 35 S
Forest, MS 39074-8830

Phone

(601) 469-8266

Fax

(601) 469-8294

NPI assigned

Jun 6, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Quentin N Burdick Comprehensive Health Care Facility

  • Rural Acute Care Hospital
  • Belcourt, ND
  • NPI 1952346934

  TX

  Medicare reassignment NPD
• Smilecare PLLC

  • General Practice Dentistry
  • Forest, MS
  • NPI 1134658602
  NPD

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1396006458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 CHILTON PL",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391107810",
            "telephone_number": "773-844-3439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SMILE CARE, PLLC",
            "address_2": "1237 HIGHWAY 35 S",
            "city": "FOREST",
            "state": "MS",
            "postal_code": "390748830",
            "telephone_number": "601-469-8266",
            "fax_number": "601-469-8294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1721 S Main St",
            "address_purpose": "LOCATION",
            "city": "West Bend",
            "state": "WI",
            "postal_code": "530954937",
            "country_code": "US",
            "telephone_number": "262-346-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNDRA",
        "first_name": "DEEPTHI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6907-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mississippi State Department of Health
• Lisa Monk
• Krishna Santasha Moore, LCSW
• Sarah Mote, OT
• Mr Discount Drugs of Forest, Inc
• Sara Bailey Murray, CFNP
• Nathan Lance Newman, CRNA
• Nissi LLC
• Paula Stacy Norman, SLT
• Lauren Oswalt

• General Practice Dentistry in Forest, MS
• Providers in Forest, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.

Verify at the official NPI Registry.