Simha Vaibhava Reddy Kukunooru, B.D.S

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DN19262 Issued in FL

Practice address

1799 66TH St N
St Petersburg, FL 33710-5537

Phone

(727) 222-3220

NPI assigned

Oct 7, 2010

Sex

Male

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 FL

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

Locations

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.

• Sunshine Periodontics and Implant Dentistry PLLC

  • Periodontics
  • Saint Petersburg, FL
  • NPI 1770308835
  NPD Authorized official

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1598074619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1799 66TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337105537",
            "telephone_number": "205-807-6322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1799 66TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337105537",
            "telephone_number": "727-222-3220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUKUNOORU",
        "first_name": "SIMHA",
        "middle_name": "VAIBHAVA REDDY",
        "name_prefix": "Dr.",
        "credential": "B.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-07",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN19262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Cyril Kuba, D.M.D
• Kristen Michelle Kubala, PT
• Jennifer Neville Kucera, M.D.
• Kimberly M Kuhn, DOM
• Keshav Kukreja, M.D.
• Peggy A. Kulpaca, PA-C
• Meghna Kumar-Pelayo, M.D.
• Ajoy Kumar, MD.
• Akshita Kumar, M.D.
• Premsai Charan Kumar, MD

• Periodontics in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Periodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.