Madhumeeta Sanam-Venkata, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901600559 Issued in MI

Practice address

11180 Gratiot Ave
Detroit, MI 48213-1363

Phone

(313) 925-3090

NPI assigned

Jul 8, 2020

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1457979205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24419 WILLOWBROOK",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483753572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11180 GRATIOT AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482131363",
            "telephone_number": "313-925-3090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26210 Harper Ave # 100",
            "address_purpose": "LOCATION",
            "city": "Saint Clair Shores",
            "state": "MI",
            "postal_code": "480812203",
            "country_code": "US",
            "telephone_number": "248-850-1809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANAM-VENKATA",
        "first_name": "MADHUMEETA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901600559",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901600559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sujith Kumar Samudrala
• Ataska Yvette Samuel I
• Jaina Sabu Samuel
• Christian Samuelson, LCSW
• Meghana Sana
• Yamne Sanchez Tame
• Alyssa Maria Sanchez
• Joselito Sanchez, MD
• Karla Sanchez, LLMSW
• Marisol Sanchez

• General Practice Dentistry in Detroit, MI
• Providers in Detroit, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; 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.