Nishanth Reddy Puchalapalli, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD 3837 Issued in NM

Practice address

701 N Main Ave
Lovington, NM 88260-3417

Phone

(408) 306-8365

NPI assigned

Jun 27, 2012

Last updated

Aug 23, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Reddy Dental

  • General Practice Dentistry
  • Hobbs, NM
  • NPI 1619648342
  NPD Authorized official
• Lea County Dental

  • General Practice Dentistry
  • Lovington, NM
  • NPI 1679931356
  NPD (past) Authorized official

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1770847436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N MAIN AVE",
            "city": "LOVINGTON",
            "state": "NM",
            "postal_code": "882603417",
            "telephone_number": "408-306-8365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N MAIN AVE",
            "city": "LOVINGTON",
            "state": "NM",
            "postal_code": "882603417",
            "telephone_number": "408-306-8365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCHALAPALLI",
        "first_name": "NISHANTH",
        "middle_name": "REDDY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-27",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD 3837",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NM",
            "license": "DD 3837",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda K. Phillips
• Prafulla Pochampally
• Heather Ponder, BT
• Nageena Potluri, MD
• Carla S. Potter, ATC
• Jessica Elaine Pyeatt
• Michael Raburn, RPH
• Rumana Rahmani, M.D.
• Thomas D Ramage, M.D.
• Kimberly Kay Reeder, RN

• General Practice Dentistry in Lovington, NM
• Providers in Lovington, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; 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.