Neelagiri Dental Group Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

NEELAGIRI DENTAL GROUP INC

Practice address

43625 Mission Blvd Ste 105
Fremont, CA 94539-5800

Phone

(510) 656-7424

Fax

(510) 226-7424

NPI assigned

Oct 30, 2021

Organization subpart

No

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

Authorized official

Name

Krishna Neelagiri, DDSNPI 1689952376

Title

President

Phone

(408) 802-5270

Specialties & licenses 1

Addresses

Other names 1

• Clove Dental Care Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Krishna Neelagiri, DDS

  • General Practice Dentistry
  • Fremont, CA
  • NPI 1689952376
  Medicare reassignment NPD Authorized official
• Hak Kyun Kim, DDS

  • Dentist
  • Berkeley, CA
  • NPI 1821583048
  Medicare reassignment NPD

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

{
    "created_epoch": "1635552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635552000000",
    "number": "1801550322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6011 MILANO TER",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945551853",
            "telephone_number": "510-402-4432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43625 MISSION BLVD STE 105",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945395800",
            "telephone_number": "510-656-7424",
            "fax_number": "510-226-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEELAGIRI DENTAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-30",
        "last_updated": "2021-10-30",
        "certification_date": "2021-10-30",
        "status": "A",
        "authorized_official_last_name": "NEELAGIRI",
        "authorized_official_first_name": "KRISHNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-802-5270",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clove Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nba Serra Residential Center
• Nba Serra Residential Center
• Andrea Patricia Neblett, CCC-SLP
• Patrick Necesario
• Rachel Needham
• Krishna Neelagiri, DDS
• Megan Neelley
• Victoria Alexandra Nejal
• Janine Nelson, R.D.H.
• Olivia Nelson

• Dental Clinic/Center in Fremont, CA
• Providers in Fremont, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.