Active NPI
Bharathi Charugundla, DMD
- Dentist
- Portland, OR
National Provider Identifier
1588086227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D9978
- Practice address
- 1320 SW 2ND Ave
Portland, OR 97201-5833 - Phone
- (503) 224-1075
- NPI assigned
- Jan 15, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D9978 | OR | Primary |
Addresses
Primary practice location
1320 SW 2ND Ave
Portland, OR 97201-5833
Mailing address
2138 NW Thorncroft Dr Apt 814
Hillsboro, OR 97124-9019
Phone (650) 279-6250
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160105002884 | OR | Order and Referring Only - Other (Physician) | 4082916218 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389744000000",
"number": "1588086227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2138 NW THORNCROFT DR APT 814",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971249019",
"telephone_number": "650-279-6250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 SW 2ND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972015833",
"telephone_number": "503-224-1075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARUGUNDLA",
"first_name": "BHARATHI",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-15",
"last_updated": "2014-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D9978",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.