Individual provider Active NPI

Pooja Yarlagadda, DDS

  • Dentist
  • Dearborn, MI
National Provider Identifier
1467023002
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901601017 Issued in MI
Practice address
16201 Ford Rd
Dearborn, MI 48126-2945
Phone
(773) 456-7071
NPI assigned
Jul 6, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901601017 MI Primary

Addresses

Primary practice location

16201 Ford Rd
Dearborn, MI 48126-2945

Mailing address

29748 Citation Cir Apt 30202
Farmington Hills, MI 48331-5847
Phone (716) 331-6973

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
I20220111000444 MI Order and Referring Only - DentistPractitioner - Dentist 8123410701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1467023002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29748 CITATION CIR APT 30202",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483315847",
            "telephone_number": "716-331-6973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16201 FORD RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262945",
            "telephone_number": "773-456-7071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YARLAGADDA",
        "first_name": "POOJA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901601017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.