Active NPI
Haritha Sambaraju, DDS
- Dentist
- Coppell, TX
National Provider Identifier
1447426150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30330
- Practice address
- 230 N Denton Tap Rd
Suite 115
Coppell, TX 75019-2134 - Phone
- (972) 393-9933
- Fax
- (972) 393-3406
- NPI assigned
- May 2, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30330 | TX | Primary |
Addresses
Primary practice location
230 N Denton Tap Rd
Suite 115
Coppell, TX 75019-2134
Mailing address
230 N Denton Tap Rd
Suite 115
Coppell, TX 75019-2134
Phone (972) 393-9933
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150728003139 | TX | Order and Referring Only - Other (Physician) | 9537473186 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30330 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coppell Modern Dentistry, PC | 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.
-
- General Practice Dentistry
- Coppell, TX
- NPI 1437455433
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411689600000",
"number": "1447426150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "230 N DENTON TAP RD",
"address_2": "SUITE 115",
"city": "COPPELL",
"state": "TX",
"postal_code": "750192134",
"telephone_number": "972-393-9933",
"fax_number": "972-393-3406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 N DENTON TAP RD",
"address_2": "SUITE 115",
"city": "COPPELL",
"state": "TX",
"postal_code": "750192134",
"telephone_number": "972-393-9933",
"fax_number": "972-393-3406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMBARAJU",
"first_name": "HARITHA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-02",
"last_updated": "2014-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "30330",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coppell, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; 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.