Harita Kodali, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

23373 Issued in TX

Practice address

355 E Westchester Pkwy Ste 200
Grand Prairie, TX 75052-2846

Phone

(972) 546-3888

Fax

(469) 619-0665

NPI assigned

Aug 28, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1578757019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 E WESTCHESTER PKWY STE 200",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750522846",
            "telephone_number": "972-546-3888",
            "fax_number": "469-619-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 E WESTCHESTER PKWY STE 200",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750522846",
            "telephone_number": "972-546-3888",
            "fax_number": "469-619-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODALI",
        "first_name": "HARITA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2014-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiner Speech Services
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• Josephat Omweno Kirochi, RN
• Electra M Kitchin, LPC-S
• Jessica Marie Knox
• Stephen A Koger, OT
• Chelsea Mae Kohutek, DC
• Sowmya Kokku
• Omolayo Kolleade
• Titilope J Komolafe

• General Practice Dentistry in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2014; 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.