Individual provider Active NPI

Sindhu Kanikicharla

  • Prosthodontics
  • Rochester, NY
National Provider Identifier
1508451303
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
000149-01 Issued in NY
Practice address
2400 S Clinton Ave Ste 125
Rochester, NY 14618-2668
Phone
(410) 706-2312
NPI assigned
Mar 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X LL879 MD
Prosthodontics 1223P0700X 000149-01 NY Primary

Addresses

Primary practice location

2400 S Clinton Ave Ste 125
Rochester, NY 14618-2668

Mailing address

625 Elmwood Ave Ofc 410
Rochester, NY 14620-2913
Phone (623) 223-0493

Other practice location 1

625 Elmwood Ave Ofc 410
Rochester, NY 14620-2913
Phone (623) 223-0493

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LL879MDMDProsthodontist
000149-01NYMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1508451303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ELMWOOD AVE OFC 410",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146202913",
            "telephone_number": "623-223-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 S CLINTON AVE STE 125",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182668",
            "telephone_number": "410-706-2312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 Elmwood Ave Ofc 410",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146202913",
            "country_code": "US",
            "telephone_number": "623-223-0493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANIKICHARLA",
        "first_name": "SINDHU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-03",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MD",
            "license": "LL879",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "000149-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.