Individual provider Active NPI

Nagarani Nagarajan, DDS

  • Dentist
  • Charlotte, NC
National Provider Identifier
1720469125
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10550 Issued in NC
Practice address
2510 Vista Dr
Charlotte, NC 28212-6253
Phone
(704) 774-6001
Fax
(704) 558-6150
NPI assigned
Jun 11, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10550 NC Primary

Addresses

Primary practice location

2510 Vista Dr
Charlotte, NC 28212-6253

Mailing address

1412 Rivendell Way
Edison, NJ 08817-2019
Phone (732) 429-3794

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

LicenseStateTypeSpecialty
10550NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Nagarani Nagarajan Concord PLLC CurrentSince Oct 1, 2023 Accepting new patients
Nagarani Nagarajan DDS.,PLLC Current Accepting new patients

Locations

2510 Vista Dr
Ste 100
Charlotte, NC 28212
Phone (704) 774-6001

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1720469125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 RIVENDELL WAY",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088172019",
            "telephone_number": "732-429-3794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 VISTA DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282126253",
            "telephone_number": "704-774-6001",
            "fax_number": "704-558-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGARAJAN",
        "first_name": "NAGARANI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "10550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.