Ar Nukala MGMT LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

AR NUKALA MGMT LLC

Doing business as

RC Family Dental

Practice address

115 FM 2453 Suite B
Royse City, TX 75189

Phone

(469) 981-0352

Fax

(469) 981-0358

NPI assigned

Aug 18, 2021

Organization subpart

No

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

Authorized official

Name

Deepa Reddy Gaddam, DDS

Title

Owner

Phone

(908) 307-0346

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• RC Family Dental Doing business as

Locations

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

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629417600000",
    "number": "1669148862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 FM 2453 SUITE B",
            "city": "ROYSE CITY",
            "state": "TX",
            "postal_code": "75189",
            "telephone_number": "469-981-0352",
            "fax_number": "469-981-0358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 FM 2453 SUITE B",
            "city": "ROYSE CITY",
            "state": "TX",
            "postal_code": "75189",
            "telephone_number": "469-981-0352",
            "fax_number": "469-981-0358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AR NUKALA MGMT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-18",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A",
        "authorized_official_last_name": "GADDAM",
        "authorized_official_first_name": "DEEPA",
        "authorized_official_middle_name": "REDDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-307-0346",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1945883",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RC Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Royse City, TX
• Providers in Royse City, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; 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.