Suman Kishore Kondragunta, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

TX28527 Issued in TX

Practice address

2400 E Oltorf St # 100B
Austin, TX 78741-4563

Phone

(512) 822-7275

NPI assigned

Jul 25, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1311552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1447538400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4215 FRANKLIN AVE",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767102529",
            "telephone_number": "346-201-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 E OLTORF ST # 100B",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787414563",
            "telephone_number": "512-822-7275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDRAGUNTA",
        "first_name": "SUMAN",
        "middle_name": "KISHORE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-25",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD3548",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "TX28527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon M. Kolton, LPC
• Sydney Maile Kometani, M.D
• Kadzumi Komiyama, LMSW
• Gregory Kon, DDS
• Melodee Annette Konde
• Vinod Kondragunta
• Bertha Genna Kondrak, LCSW
• Claire Kondrotas
• Bharathi Prathap Kondur, MD
• Sabrina Lee Kones, PMHNP-BC, LCSW

• Dentist in Austin, TX
• Providers in Austin, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; 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.

Verify at the official NPI Registry.