Active NPI
Karthik Muppalla
- Dentist
- Laurel, MD
National Provider Identifier
1679149124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 17628
- Practice address
- 7350 Van Dusen Rd Ste 440
Laurel, MD 20707-5265 - Phone
- (941) 405-1500
- NPI assigned
- Jun 3, 2021
- Last updated
- Mar 13, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 17628 | MD | Primary |
Addresses
Primary practice location
7350 Van Dusen Rd Ste 440
Laurel, MD 20707-5265
Mailing address
10210 Sunway Ter
Ellicott City, MD 21042-5848
Phone (410) 782-9450
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17628 | MD | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710288000000",
"number": "1679149124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10210 SUNWAY TER",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210425848",
"telephone_number": "410-782-9450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7350 VAN DUSEN RD STE 440",
"city": "LAUREL",
"state": "MD",
"postal_code": "207075265",
"telephone_number": "941-405-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUPPALLA",
"first_name": "KARTHIK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-06-03",
"last_updated": "2024-03-13",
"certification_date": "2024-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "17628",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laurel, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.