Active NPI
Srujana Kraleti, DMD
- Pediatric Dentistry
- Newark, NJ
National Provider Identifier
1487123386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 39358
- Practice address
- 741 Broadway
Newark, NJ 07104-4309 - Phone
- (973) 483-1300
- Fax
- (973) 676-1396
- NPI assigned
- Nov 20, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22DIO2738300 | NJ | |
| Pediatric Dentistry | 1223P0221X | 39358 | TX | Primary |
Addresses
Primary practice location
741 Broadway
Newark, NJ 07104-4309
Mailing address
1201 Summit Ave Apt 414
Jersey City, NJ 07307-3174
Phone (512) 920-9788
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39358 | TX | MD | Clinical Psychologist |
| 22DIO2738300 | NJ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704067200000",
"number": "1487123386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 SUMMIT AVE APT 414",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073073174",
"telephone_number": "512-920-9788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "741 BROADWAY",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071044309",
"telephone_number": "973-483-1300",
"fax_number": "973-676-1396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRALETI",
"first_name": "SRUJANA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-20",
"last_updated": "2024-01-01",
"certification_date": "2024-01-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "22DIO2738300",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "39358",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.