NPIMap

Organization Active NPI

Dr.Anu Deshpande BDS DMD Ms PA

  • Endodontics
  • Melbourne, FL
National Provider Identifier
1669067682
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
DR.ANU DESHPANDE BDS DMD MS PA
Practice address
330 N Babcock St Ste 102
Melbourne, FL 32935-7324
Phone
(321) 208-7979
NPI assigned
Mar 2, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Authorized official

Name
Dr. Annapurna Sridher Deshpande, DMDNPI 1528296241
Title
President
Phone
(321) 208-7979

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
EndodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

330 N Babcock St Ste 102
Melbourne, FL 32935-7324

Mailing address

330 N Babcock St Ste 102
Melbourne, FL 32935-7324
Phone (321) 208-7979

Other names 1

  • Pristine Endodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dranu Deshpande BDS DMD Ms PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

330 N Babcock St
Ste 102
Melbourne, FL 32935
Phone (321) 208-7979

Practitioners & affiliated clinicians

Practitioners 1

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": "1614643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687392000000",
    "number": "1669067682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N BABCOCK ST STE 102",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329357324",
            "telephone_number": "321-208-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N BABCOCK ST STE 102",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329357324",
            "telephone_number": "321-208-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR.ANU DESHPANDE BDS DMD MS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-02",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-20",
        "status": "A",
        "authorized_official_last_name": "DESHPANDE",
        "authorized_official_first_name": "ANNAPURNA",
        "authorized_official_middle_name": "SRIDHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-208-7979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pristine Endodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pristine Endodontics",
            "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 Jun 22, 2023; 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.