Thanmayi Panguluri, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

22DI03075400 Issued in NJ

Practice address

472 Broadway
Bayonne, NJ 07002-7114

Phone

(201) 380-8900

NPI assigned

Jul 18, 2023

Last updated

Mar 31, 2025By the provider in NPPES

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.

• Bayonne Dental Associates PC

  • Dental Clinic/Center
  • Bayonne, NJ
  • NPI 1033970082
  NPD

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1700565520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "472 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070027114",
            "telephone_number": "571-635-7269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "472 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070027114",
            "telephone_number": "201-380-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANGULURI",
        "first_name": "THANMAYI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-18",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401418577",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI03075400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Palisades Surgical Group LLC
• Mary Catherine Palomino
• Drashti Pandya
• Het Sanjay Pandya, MD
• Sharad Pandya
• Joseph Gerard Paolini, RPH
• Neloufar Papasmiris, PHARMD
• John W Park, PHARMD
• Minah Park
• Myoung Ae Park, NP

• Dentist in Bayonne, NJ
• Providers in Bayonne, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.