Nikita Kuppanda

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

10316 Issued in AZ

Practice address

21116 N John Wayne Pkwy Ste B7
Maricopa, AZ 85139-2932

Phone

(520) 568-3828

Fax

(520) 568-0443

NPI assigned

Sep 8, 2015

Sex

Female

Sole proprietor

Yes

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Super Smiles Maricopa PLLC

  • Pediatric Dentistry
  • Maricopa, AZ
  • NPI 1891556502
  NPD Authorized official
• Super Smiles 4 Kids CG, PLLC

  dba Super Smiles 4 Families

  • General Practice Dentistry
  • Casa Grande, AZ
  • NPI 1144901547
  NPD (past)

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

{
    "created_epoch": "1441670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1649648668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21116 N JOHN WAYNE PKWY STE B7",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851392932",
            "telephone_number": "520-568-3828",
            "fax_number": "520-568-0443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21116 N JOHN WAYNE PKWY STE B7",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851392932",
            "telephone_number": "520-568-3828",
            "fax_number": "520-568-0443"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1295 E Florence Blvd Ste 4",
            "address_purpose": "LOCATION",
            "city": "Casa Grande",
            "state": "AZ",
            "postal_code": "851224299",
            "country_code": "US",
            "telephone_number": "520-436-0843",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUPPANDA",
        "first_name": "NIKITA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-08",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD4368",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "10316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Konadu Family
• Ladonna J Korittky, RN
• Barbara L Koudelka, NMD
• Karen Ann Kramarczyk, DDS
• KT Homes LLC
• L.I.G. Investment Group, LLC (Sunshine Family Healthcare Center)
• La Grace Home Care Services LLC
• La Laser Center PC, a Professional Medical Corporation (Maricopa Dermatology & Skin Cancer)
• Carolyn Renee Lacy
• David Lar, MD

• Pediatric Dentistry in Maricopa, AZ
• Providers in Maricopa, AZ by specialty
• Pediatric Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.