Prashant Charugundla, DDS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

D11891 Issued in OR

Practice address

3332 N Lombard St Ste C
Portland, OR 97217-1258

Phone

(503) 548-2006

Fax

(503) 548-2012

NPI assigned

Mar 23, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 15, 2025 through Oct 15, 2027

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Summit Oregon LLC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Portland, OR
  • NPI 1205664844

  Oral and Maxillofacial Surgery

  NPD Authorized official

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1700317401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3332 N LOMBARD ST STE C",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972171258",
            "telephone_number": "503-548-2006",
            "fax_number": "503-548-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3332 N LOMBARD ST STE C",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972171258",
            "telephone_number": "503-548-2006",
            "fax_number": "503-548-2012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5880 NE Cornell Rd",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971249075",
            "country_code": "US",
            "telephone_number": "503-420-3997",
            "fax_number": "866-268-9618",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2021 Concert Dr Fl 3",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234568082",
            "country_code": "US",
            "telephone_number": "757-668-7713",
            "fax_number": "757-668-7711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Riverview Ave Ste 3",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235101065",
            "country_code": "US",
            "telephone_number": "757-668-7713",
            "fax_number": "757-668-7711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARUGUNDLA",
        "first_name": "PRASHANT",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-23",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "OR",
            "license": "D11891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "poms@chkd.org",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "301 Riverview Ave Ste 3",
            "city": "Norfolk",
            "state": "VA",
            "country_code": "US",
            "postal_code": "235101065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Taylor Charron, MD
• Jordan Kimble Charters, L.M.T.
• Michelle Chartrand
• Spencer James Chartrand
• Bharathi Charugundla, DMD
• Jane Charvat, PT
• Casandra Chase, PSS
• Charles Comstock Chase, CAA
• Gillian Chase, ND
• Margot Elizabeth Chase, PA-C

• Oral & Maxillofacial Surgery (D.M.D.) in Portland, OR
• Providers in Portland, OR by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.