Srinivasa Reddy Pathagunti, BDS, MS, MPH

Primary specialty

DentistTaxonomy code 122300000X

License

35888 Issued in TX

Practice address

7010 S Zarzamora St Ste 113
San Antonio, TX 78224-1148

Phone

(210) 921-0603

NPI assigned

Mar 10, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1730714767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7010 S ZARZAMORA ST STE 113",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782241148",
            "telephone_number": "210-921-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7010 S ZARZAMORA ST STE 113",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782241148",
            "telephone_number": "210-921-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATHAGUNTI",
        "first_name": "SRINIVASA REDDY",
        "name_prefix": "Dr.",
        "credential": "BDS, MS, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-10",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "35888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vipul Patel, RRT
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• Pathnet Lab Institute South

• Dentist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.