NPIMap

Organization Active NPI

Avanthi Kopuri, DMD, MSD, Mha, PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Melbourne, FL
National Provider Identifier
1629617154
Registry record updated Jan 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
AVANTHI KOPURI, DMD, MSD, MHA, PLLC
Practice address
2555 W New Haven Ave
Melbourne, FL 32904-3701
Phone
(321) 728-9999
Fax
(321) 728-5925
NPI assigned
Jan 1, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2020

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

Authorized official

Name
Dr. Avanthi Kopuri, DMD, MSDNPI 1699176990
Title
President
Phone
(305) 788-4415

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

2555 W New Haven Ave
Melbourne, FL 32904-3701

Mailing address

10322 Kensington Shore Dr
Orlando, FL 32827-7307
Phone (305) 788-4415

Other practice location 1

3010 S Fiske Blvd
Rockledge, FL 32955-4302
Phone (321) 638-4455

Other practice location 2

730 Sand Lake Rd Ste 124
Orlando, FL 32809-7747
Phone (407) 850-2355

Other names 1

  • Central Florida Orthodontic Specialists Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Avanthi Kopuri DMD MSD Mha PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3010 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 638-4455

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1577836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577836800000",
    "number": "1629617154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10322 KENSINGTON SHORE DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277307",
            "telephone_number": "305-788-4415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 W NEW HAVEN AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329043701",
            "telephone_number": "321-728-9999",
            "fax_number": "321-728-5925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3010 S Fiske Blvd",
            "address_purpose": "LOCATION",
            "city": "Rockledge",
            "state": "FL",
            "postal_code": "329554302",
            "country_code": "US",
            "telephone_number": "321-638-4455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "730 Sand Lake Rd Ste 124",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328097747",
            "country_code": "US",
            "telephone_number": "407-850-2355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AVANTHI KOPURI, DMD, MSD, MHA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-01",
        "last_updated": "2020-01-01",
        "certification_date": "2020-01-01",
        "status": "A",
        "authorized_official_last_name": "KOPURI",
        "authorized_official_first_name": "AVANTHI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-788-4415",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MSD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Florida Orthodontic Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2020; 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.