Active NPI
Naga Azzarapu
- Dentist
- Tyler, TX
National Provider Identifier
1588337679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 37610
- Practice address
- 212 Old Grande Blvd Ste B224
Tyler, TX 75703-4277 - Phone
- (732) 757-9377
- NPI assigned
- Jul 26, 2021
- Last updated
- Nov 1, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 37610 | TX | Primary |
Addresses
Primary practice location
212 Old Grande Blvd Ste B224
Tyler, TX 75703-4277
Mailing address
212 Old Grande Blvd
Tyler, TX 75703-4226
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
| License | State | Type | Specialty |
|---|---|---|---|
| 37610 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730419200000",
"number": "1588337679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "212 OLD GRANDE BLVD",
"city": "TYLER",
"state": "TX",
"postal_code": "757034226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "212 OLD GRANDE BLVD STE B224",
"city": "TYLER",
"state": "TX",
"postal_code": "757034277",
"telephone_number": "732-757-9377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AZZARAPU",
"first_name": "NAGA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-26",
"last_updated": "2024-11-01",
"certification_date": "2024-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "37610",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
- Azalea Orthopedic & Sports Medicine Clinic PA
- Azalea Place Operating Company
- Samareh Cunningham Azar, MD
- Jasmine Azghani Vardeman, NP-C
- Azleway Inc.
- Eli Azzi, MD
- B Tano, M.D., P.a. (The Center for Asthma, Allergy, Immunology & Hormone Health (TCAAIH))
- Daniel Baber, MD
- Rachel Rene Baber
- Heather Faith Babin, CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.