Individual provider Active NPI

Anurag R Gudeti, DDS

  • Dentist
  • Wesley Chapel, FL
National Provider Identifier
1629630074
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN25738 Issued in FL
Practice address
1644 Bruce B Downs Blvd
Wesley Chapel, FL 33544-8600
Phone
(813) 333-5277
NPI assigned
Jul 6, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN25738 FL Primary
Dentist 122300000X 2901600218 MI

Addresses

Primary practice location

1644 Bruce B Downs Blvd
Wesley Chapel, FL 33544-8600

Mailing address

1644 Bruce B Downs Blvd
Wesley Chapel, FL 33544-8600
Phone (248) 885-3807

Other practice location 1

2035 Asher Ct
East Lansing, MI 48823-8480
Phone (517) 394-1495

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
DN25738FLMDDentist
2901600218MIMDDentist

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1562371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1629630074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1644 BRUCE B DOWNS BLVD",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335448600",
            "telephone_number": "248-885-3807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1644 BRUCE B DOWNS BLVD",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335448600",
            "telephone_number": "813-333-5277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2035 Asher Ct",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488238480",
            "country_code": "US",
            "telephone_number": "517-394-1495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUDETI",
        "first_name": "ANURAG",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-06",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN25738",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901600218",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wesley Chapel, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; 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.