Individual provider Active NPI

Sharadha Avula, DDS

  • Pediatric Dentistry
  • Baltimore, MD
National Provider Identifier
1598956427
Registry record updated Aug 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
11684 Issued in MD
Practice address
301 Saint Paul PL
Baltimore, MD 21202-2102
Phone
(410) 332-9262
Fax
(410) 543-4253
NPI assigned
Aug 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 11684 MD Primary

Addresses

Primary practice location

301 Saint Paul PL
Baltimore, MD 21202-2102

Mailing address

301 Saint Paul PL
Baltimore, MD 21202-2102
Phone (410) 332-9262

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
11684MDMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Prasanthi Children'S Dentistry,LLC Pediatric Dentistry Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186358400000",
    "number": "1598956427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SAINT PAUL PL",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022102",
            "telephone_number": "410-332-9262",
            "fax_number": "410-543-4253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SAINT PAUL PL",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022102",
            "telephone_number": "410-332-9262",
            "fax_number": "410-543-4253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVULA",
        "first_name": "SHARADHA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "11684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; 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.