Raghavendra Sumanth Phani Challa, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN1858555 Issued in MA

Practice address

230 Maple St Ste 1
Holyoke, MA 01040-5140

Phone

(413) 420-2200

Fax

(413) 539-9472

NPI assigned

Jan 23, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: rchalla18813@direct.ctc.masshiway.net

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.

• Holyoke Health Center Inc.

  • Community/Retail Pharmacy
  • Holyoke, MA
  • NPI 1477519684
  NPD (past)

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1508320532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 MAPLE ST STE 1",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010405140",
            "telephone_number": "413-420-2200",
            "fax_number": "413-539-9472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 MAPLE ST STE 1",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010405140",
            "telephone_number": "413-420-2200",
            "fax_number": "413-539-9472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHALLA",
        "first_name": "RAGHAVENDRA",
        "middle_name": "SUMANTH PHANI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-23",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00203866",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1858555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Center for Resilience, PC
• Jennifer Cerreta, RN
• CFM Buckley-South LLC
• Denise Ann Chadwick, MSW
• Sean Michael Chaez
• Parisa Chamani, D.D.S.
• Natalie Anne Champagne, LCSW
• Kevin Chandler
• Deepa Chandrasekaran, MD
• Grace Chang, PH.D.

• General Practice Dentistry in Holyoke, MA
• Providers in Holyoke, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.