Individual provider Active NPI

Harika Rao Mendu, DMD

  • Dentist
  • Union, MO
National Provider Identifier
1427618891
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2020035764 Issued in MO
Practice address
1780 Old Highway 50 E Ste 102
Union, MO 63084-3397
Phone
(844) 853-8937
NPI assigned
Jun 18, 2019
Last updated
Sep 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2020035764 MO Primary
General Practice Dentistry 1223G0001X DS042234 PA

Addresses

Primary practice location

1780 Old Highway 50 E Ste 102
Union, MO 63084-3397

Mailing address

1800 Community
Clinton, MO 64735-8804
Phone (660) 885-8131

Other practice location 1

1032 Crosswinds Ct
Wentzville, MO 63385-4836
Phone (844) 853-8937

Other practice location 2

704 E Highway 28
Owensville, MO 65066-1588
Phone (844) 853-8937

Other practice location 3

91 Troy Sq Ste 101
Troy, MO 63379-3228
Phone (844) 853-8937

Other practice location 4

19515 Brune Pkwy
Warrenton, MO 63383-6505
Phone (844) 853-8937

Other practice location 5

102 Compass Point Dr
Saint Charles, MO 63301-4404
Phone (844) 853-8937

Other practice location 6

2645 Muegge Rd Ste 202
Saint Charles, MO 63303-3145
Phone (844) 853-8937

Other practice location 7

101 Progress Pkwy
Sullivan, MO 63080-2359
Phone (844) 853-8937

Other identifiers 1

IdentifierTypeStateIssuer
400090529MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20220916000480 MO Practitioner - Dentist 1850776568 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS042234PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Health, Inc CurrentSince Jul 1, 2022 Accepting new patients
Compass Health, Inc CurrentSince Jul 1, 2022 Accepting new patients

Locations

1800 Community
Clinton, MO 64735
Phone (660) 885-8131

1800 Community
#B
Clinton, MO 64735

704 E Highway 28
Owensville, MO 65066
Phone (573) 437-2959

102 Compass Point Dr
Saint Charles, MO 63301
Phone (636) 332-8318

2645 Muegge Rd
Saint Charles, MO 63303
Phone (636) 939-6868

2645 Muegge Rd
Ste 202
Saint Charles, MO 63303

101 Progress Pkwy
Sullivan, MO 63080
Phone (573) 468-3555

91 Troy Sq
Troy, MO 63379

91 Troy Sq
Ste 101
Troy, MO 63379

1780 Old Highway 50 E
Ste 102
Union, MO 63084
Phone (636) 583-1611

19515 Brune Pkwy
Warrenton, MO 63383
Phone (636) 235-4049

1030 Wolfrum Rd
Weldon Spring, MO 63304
Phone (314) 339-7732

1032 Crosswinds Ct
Wentzville, MO 63385
Phone (636) 332-6000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1427618891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "660-885-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 OLD HIGHWAY 50 E STE 102",
            "city": "UNION",
            "state": "MO",
            "postal_code": "630843397",
            "telephone_number": "844-853-8937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1032 Crosswinds Ct",
            "address_purpose": "LOCATION",
            "city": "Wentzville",
            "state": "MO",
            "postal_code": "633854836",
            "country_code": "US",
            "telephone_number": "844-853-8937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "704 E Highway 28",
            "address_purpose": "LOCATION",
            "city": "Owensville",
            "state": "MO",
            "postal_code": "650661588",
            "country_code": "US",
            "telephone_number": "844-853-8937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "91 Troy Sq Ste 101",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MO",
            "postal_code": "633793228",
            "country_code": "US",
            "telephone_number": "844-853-8937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19515 Brune Pkwy",
            "address_purpose": "LOCATION",
            "city": "Warrenton",
            "state": "MO",
            "postal_code": "633836505",
            "country_code": "US",
            "telephone_number": "844-853-8937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "102 Compass Point Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Charles",
            "state": "MO",
            "postal_code": "633014404",
            "country_code": "US",
            "telephone_number": "844-853-8937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2645 Muegge Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Saint Charles",
            "state": "MO",
            "postal_code": "633033145",
            "country_code": "US",
            "telephone_number": "844-853-8937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Progress Pkwy",
            "address_purpose": "LOCATION",
            "city": "Sullivan",
            "state": "MO",
            "postal_code": "630802359",
            "country_code": "US",
            "telephone_number": "844-853-8937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDU",
        "first_name": "HARIKA",
        "middle_name": "RAO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2020035764",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS042234",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400090529",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, MO

Sources for this page

Verify at the official NPI Registry.