Individual provider Active NPI

Rohit Somasundar Reddy, D.D.S

  • Dentist
  • Ann Arbor, MI
National Provider Identifier
1447409800
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901020572 Issued in MI
Practice address
760 W Eisenhower Pkwy
Suite 310
Ann Arbor, MI 48103-5890
Phone
(734) 996-9966
Fax
(734) 996-4974
NPI assigned
Sep 10, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901020572 MI Primary

Addresses

Primary practice location

760 W Eisenhower Pkwy
Suite 310
Ann Arbor, MI 48103-5890

Mailing address

760 W Eisenhower Pkwy
Suite 310
Ann Arbor, MI 48103-5890
Phone (734) 996-9966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160122000956 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0749583888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Abc Dental PC Dentist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1447409800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 W EISENHOWER PKWY",
            "address_2": "SUITE 310",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481035890",
            "telephone_number": "734-996-9966",
            "fax_number": "734-996-4974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 W EISENHOWER PKWY",
            "address_2": "SUITE 310",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481035890",
            "telephone_number": "734-996-9966",
            "fax_number": "734-996-4974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "ROHIT",
        "middle_name": "SOMASUNDAR",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-10",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.