Active NPI
Krishna Chandra Komanduri
- Dentist
- Aurora, CO
National Provider Identifier
1740553338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- CO-6800
- Practice address
- 12343 E Cornell Ave
#17
Aurora, CO 80014 - Phone
- (720) 748-7902
- Fax
- (303) 341-4463
- NPI assigned
- Feb 14, 2012
- 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 | CO-6800 | CO | Primary |
Addresses
Primary practice location
12343 E Cornell Ave
#17
Aurora, CO 80014
Mailing address
12343 E Cornell Ave
#17
Aurora, CO 80014
Phone (720) 748-7902
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 |
|---|---|---|---|
| CO-6800 | CO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329177600000",
"number": "1740553338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12343 E CORNELL AVE",
"address_2": "#17",
"city": "AURORA",
"state": "CO",
"postal_code": "80014",
"telephone_number": "720-748-7902",
"fax_number": "303-341-4463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12343 E CORNELL AVE",
"address_2": "#17",
"city": "AURORA",
"state": "CO",
"postal_code": "80014",
"telephone_number": "720-748-7902",
"fax_number": "303-341-4463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOMANDURI",
"first_name": "KRISHNA",
"middle_name": "CHANDRA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-14",
"last_updated": "2012-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "CO-6800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.