Mugdha Sunil Raut

Primary specialty

DentistTaxonomy code 122300000X

License

111713 Issued in CA

Practice address

240 S 40TH St
Office of Clinical Affairs-S6A Evans
Philadelphia, PA 19104-6030

Phone

(215) 573-2588

NPI assigned

Dec 16, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1671148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1609588060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 S 40TH ST",
            "address_2": "OFFICE OF CLINICAL AFFAIRS-S6A EVANS",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191046030",
            "telephone_number": "215-573-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 S 40TH ST",
            "address_2": "OFFICE OF CLINICAL AFFAIRS-S6A EVANS",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191046030",
            "telephone_number": "215-573-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAUT",
        "first_name": "MUGDHA",
        "middle_name": "SUNIL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-16",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "111713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Rau, BSN MPH RN
• Lauren Raudenbush, CRNP
• Grace Raup, PA-C
• Sydney Marie Rausa, PA-C
• Jennifer Rauscher, CRNP
• Anisha N. Raval, O.D.
• Parvaneh Ravandoost, M.D.
• Lisa Ann Ravener, M.D.
• Stephanie Ravett, D.M.D.
• Lisa Ann Ravetz, DMD

• Dentist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; 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.