Individual provider Active NPI

Sumesh Potluri, DMD

  • Dentist
  • Silver Spring, MD
National Provider Identifier
1508021783
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.022598 Issued in OH
Practice address
10750 Columbia Pike Ste 210
Silver Spring, MD 20901-4454
Phone
(440) 915-1272
NPI assigned
Jul 27, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 14941 MD
Dentist 122300000X 30.022598 OH Primary

Addresses

Primary practice location

10750 Columbia Pike Ste 210
Silver Spring, MD 20901-4454

Mailing address

10750 Columbia Pike Ste 210
Silver Spring, MD 20901-4454
Phone (440) 915-1272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20150305000603 MD Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 6406172659

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.022598OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Hani Ashqar DDS and Partners LLC Past Accepting new patients
Sumesh Potluri DMD MSD PC Endodontics PastSince Dec 29, 2024 Accepting new patients
James M. Wensink DDS Inc. Dentist Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1217116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1508021783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10750 COLUMBIA PIKE STE 210",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209014454",
            "telephone_number": "440-915-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10750 COLUMBIA PIKE STE 210",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209014454",
            "telephone_number": "440-915-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTLURI",
        "first_name": "SUMESH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-27",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MD",
            "license": "14941",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.022598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.