Northeastern Dentistry at Bellmawr LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

NORTHEASTERN DENTISTRY AT BELLMAWR LLC

Practice address

815 Creek Road
Bellmawr, NJ 08031

Phone

(856) 325-0560

NPI assigned

Jul 7, 2023

Last updated

Jul 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sujit Kondapaneni

Title

President

Phone

(856) 325-0560

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kavitha Chadhalavada

  • Dentist
  • Philadelphia, PA
  • NPI 1295924736
  NPD

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

{
    "created_epoch": "1688688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688688000000",
    "number": "1467130666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 SUMMIT RD",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080544748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 CREEK ROAD",
            "city": "BELLMAWR",
            "state": "NJ",
            "postal_code": "08031",
            "telephone_number": "856-325-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEASTERN DENTISTRY AT BELLMAWR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-07",
        "last_updated": "2023-07-07",
        "certification_date": "2023-06-29",
        "status": "A",
        "authorized_official_last_name": "KONDAPANENI",
        "authorized_official_first_name": "SUJIT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-325-0560"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Bellmawr, NJ
• Providers in Bellmawr, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; 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.