Individual provider Active NPI

Muralidhar Mupparapu, DMD

  • Oral and Maxillofacial Radiology Dentistry
  • Newark, NJ
National Provider Identifier
1770623134
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Radiology DentistryTaxonomy code 1223X0008X
License
22DI02136300 Issued in NJ
Practice address
110 Bergen St
D-860
Newark, NJ 07103-2495
Phone
(973) 972-0348
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Radiology Dentistry 1223X0008X 22DI02136300 NJ Primary

Addresses

Primary practice location

110 Bergen St
D-860
Newark, NJ 07103-2495

Mailing address

110 Bergen St
D-860
Newark, NJ 07103-2495
Phone (973) 972-0348

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170321000933 NJ Practitioner - Oral SurgeryPractitioner - Diagnostic Radiology 1052624350 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI021363NJMDOral and Maxillofacial Radiology Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers School of Dental Medicine CurrentSince Jan 8, 2017 Accepting new patients
Rutgers School of Dental Medicine CurrentSince Jan 8, 2017 Accepting new patients

Locations

110 Bergen St
#D860
Newark, NJ 07103
Phone (973) 972-2453

110 Bergen St
#B842A
Newark, NJ 07103

110 Bergen St
#D718
Newark, NJ 07103
Phone (973) 972-4242

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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1770623134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BERGEN ST",
            "address_2": "D-860",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032495",
            "telephone_number": "973-972-0348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BERGEN ST",
            "address_2": "D-860",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032495",
            "telephone_number": "973-972-0348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUPPARAPU",
        "first_name": "MURALIDHAR",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0008X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": "NJ",
            "license": "22DI02136300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.