Individual provider Active NPI

Sunitha P Chinnakonda, DDS

  • General Practice Dentistry
  • Princeton, NJ
National Provider Identifier
1508089822
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02042400 Issued in NJ
Practice address
3495 US Highway 1
Princeton, NJ 08540-5933
Phone
(609) 514-1666
NPI assigned
Apr 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DI02042400 NJ Primary

Addresses

Primary practice location

3495 US Highway 1
Princeton, NJ 08540-5933

Mailing address

23 Roosevelt Way
Robbinsville, NJ 08691
Phone (609) 448-8353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20160321000938 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0244537157

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02042400NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508089822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 ROOSEVELT WAY",
            "city": "ROBBINSVILLE",
            "state": "NJ",
            "postal_code": "08691",
            "telephone_number": "609-448-8353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3495 US HIGHWAY 1",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085405933",
            "telephone_number": "609-514-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHINNAKONDA",
        "first_name": "SUNITHA",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02042400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

Verify at the official NPI Registry.