NPIMap

Organization Active NPI

Madugula LLC

Doing business as Aspen Dental

  • Dentist
  • Beaverton, OR
National Provider Identifier
1760727234
Registry record updated Dec 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9735 Issued in OR
Legal business name
MADUGULA LLC
Doing business as
Aspen Dental
Practice address
2235 NW Town Center Dr
Beaverton, OR 97006
Phone
(503) 207-0510
Fax
(503) 466-3975
NPI assigned
Dec 10, 2012
Last updated
Dec 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2012

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

Authorized official

Name
Dr. Kala Sagar Madugula, DMD
Title
Owner
Phone
(315) 454-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9735 OR Primary

Addresses

Primary practice location

2235 NW Town Center Dr
Beaverton, OR 97006

Mailing address

PO Box 3189
Syracuse, NY 13220-3189
Phone (315) 454-6000

Other names 1

  • Aspen Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1355097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355097600000",
    "number": "1760727234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189",
            "telephone_number": "315-454-6000",
            "fax_number": "866-803-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 NW TOWN CENTER DR",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "97006",
            "telephone_number": "503-207-0510",
            "fax_number": "503-466-3975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADUGULA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-10",
        "last_updated": "2012-12-10",
        "status": "A",
        "authorized_official_last_name": "MADUGULA",
        "authorized_official_first_name": "KALA",
        "authorized_official_middle_name": "SAGAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-454-6000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "9735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspen Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.

Verify at the official NPI Registry.