Anusha Ganta Thatishetty, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

32839 Issued in TX

Practice address

3030 LBJ Fwy Ste 1400
Dallas, TX 75234-2766

Phone

(972) 663-5314

NPI assigned

Jan 7, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Anusha Ganta Former name

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": "1483747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1487190906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4338 NORMANDY AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752052042",
            "telephone_number": "912-704-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 LBJ FWY STE 1400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752342766",
            "telephone_number": "972-663-5314"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5515 Kennedy Blvd E",
            "address_purpose": "LOCATION",
            "city": "West New York",
            "state": "NJ",
            "postal_code": "070933510",
            "country_code": "US",
            "telephone_number": "912-704-1980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THATISHETTY",
        "first_name": "ANUSHA",
        "middle_name": "GANTA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02659900",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "32839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANUSHA",
            "last_name": "GANTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.