Active NPI
Sharavana Kumar Gajapathi, D.D.S, M.P.H
- Pediatric Dentistry
- Henderson, TX
National Provider Identifier
1407045735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 24289
- Practice address
- 1115 US Highway 259 S
Henderson, TX 75654-3629 - Phone
- (903) 392-8251
- NPI assigned
- Oct 23, 2007
- Last updated
- Jul 1, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 24289 | TX | |
| Dentist | 122300000X | D12360 | MN | |
| Pediatric Dentistry | 1223P0221X | 24289 | TX | Primary |
Addresses
Primary practice location
1115 US Highway 259 S
Henderson, TX 75654-3629
Mailing address
1115 US Highway 259 S
Henderson, TX 75654-3629
Phone (903) 392-8251
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 203375501 | Medicaid | TX | |
| 206661513 | Medicaid | TX |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D12360 | MN | MD | Dentist |
| 24289 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DHHS, PHS, Naihs, Gallup Indian Medical Center | Past | Accepting new patients |
Interoperability endpoints
- sgajapathi450418@ahs.direct-ci.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Tohatchi Health Center
- Federal Public Health Clinic/Center
- Tohatchi, NM
- NPI 1902875594
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593561600000",
"number": "1407045735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1115 US HIGHWAY 259 S",
"city": "HENDERSON",
"state": "TX",
"postal_code": "756543629",
"telephone_number": "903-392-8251",
"fax_number": "903-392-8207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 US HIGHWAY 259 S",
"city": "HENDERSON",
"state": "TX",
"postal_code": "756543629",
"telephone_number": "903-392-8251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAJAPATHI",
"first_name": "SHARAVANA KUMAR",
"name_prefix": "Dr.",
"credential": "D.D.S, M.P.H",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-23",
"last_updated": "2020-07-01",
"certification_date": "2020-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "24289",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D12360",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "24289",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "203375501",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "206661513",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Henderson, TX
- Elwanda French, CRNA
- Corneil Kimberly Fretty, DDS
- Frio Hospital District (Autumn Leaves Nursing and Rehab)
- Nino Fuller, AGACNP-BC
- Furqueron & Jackson Dentistry Partnership (Henderson Family Dentistry)
- Gibson & Harshaw, LLC (AssistCare)
- Robert Joseph Griffith, FNP-C
- Mark A Hackbarth, MD
- Dwight M Hall, CRNA
- Hamilton County Hospital District (Avir at Henderson)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.