Subash Mutyala, P.a.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

23436 Issued in TX

Legal business name

SUBASH MUTYALA, P.A.

Doing business as

Little Explorers Pediatric Dentistry

Practice address

1500 A W Grimes Blvd
Round Rock, TX 78664-7836

Phone

(512) 238-7300

Fax

(512) 238-7301

NPI assigned

Feb 16, 2010

Last updated

Feb 16, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Subash Mutyala, DDSNPI 1639361538

Title

Owner

Phone

(512) 238-7300

Specialties & licenses 1

Addresses

Other names 1

• Little Explorers Pediatric Dentistry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Subash Mutyala, D.D.S.

  • Pediatric Dentistry
  • Round Rock, TX
  • NPI 1639361538
  Authorized official Same address or phone

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

{
    "created_epoch": "1266278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266278400000",
    "number": "1760704944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 A W GRIMES BLVD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786647836",
            "telephone_number": "512-238-7300",
            "fax_number": "512-238-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 A W GRIMES BLVD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786647836",
            "telephone_number": "512-238-7300",
            "fax_number": "512-238-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBASH MUTYALA, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-16",
        "last_updated": "2010-02-16",
        "status": "A",
        "authorized_official_last_name": "MUTYALA",
        "authorized_official_first_name": "SUBASH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-238-7300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "23436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Little Explorers Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shannon L. Struble, BCBA
• Ashley Stubblefield, LCSW
• Christiana Corina Stubblefield, SLP
• Emily Studebaker, OD
• Biqi Su
• Kaitlin Sucher, M.S. CCC-SLP
• Jessica Lynn Sugamele, LPC
• Emily Sullivan
• Erin C Sullivan, D.P.T
• Kim Sullivan, MA, LPC, RPT, NCC

• Pediatric Dentistry in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2010; 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.