University Dermatology Associates, PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

UNIVERSITY DERMATOLOGY ASSOCIATES, PLLC

Practice address

1120 19TH St NW
Suite 250
Washington, DC 20036-3605

Phone

(202) 955-6995

Fax

(202) 955-3915

NPI assigned

Jun 6, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Radha Mikkilineni, MD

Title

Owner

Phone

(202) 955-6995

Specialties & licenses 1

Addresses

Other names 1

• Radha Mikkilineni, MD, PLLC Former legal business name

Locations

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206921600000",
    "number": "1437352788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 19TH ST NW",
            "address_2": "SUITE 250",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200363605",
            "telephone_number": "202-955-6995",
            "fax_number": "202-955-3915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 19TH ST NW",
            "address_2": "SUITE 250",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200363605",
            "telephone_number": "202-955-6995",
            "fax_number": "202-955-3915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY DERMATOLOGY ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2008-03-31",
        "status": "A",
        "authorized_official_last_name": "MIKKILINENI",
        "authorized_official_first_name": "RADHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "202-955-6995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Radha Mikkilineni, MD, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Dermatology Physician in Washington, DC
• Providers in Washington, DC by specialty
• Dermatology Physician in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; 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.