Active NPI
Prathima Neruganti
- Dentist
- Lumberton, NJ
National Provider Identifier
1801940721
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22D102299300
- Practice address
- 1636 Route 38 Ste 21
Lumberton Plaza
Lumberton, NJ 08048 - Phone
- (609) 914-5050
- Fax
- (609) 914-5059
- NPI assigned
- Jan 22, 2007
- Last updated
- Aug 6, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 22D102299300 | NJ | Primary |
Addresses
Primary practice location
1636 Route 38 Ste 21
Lumberton Plaza
Lumberton, NJ 08048
Mailing address
1636 Route 38 Ste 21
Lumberton Plaza
Lumberton, NJ 08048-2987
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150720001162 | NJ | Order and Referring Only - Dentist | 2769795806 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22D102299300 | NJ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Health Associates PA | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Lumberton, NJ
- NPI 1932288743
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533513600000",
"number": "1801940721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1636 ROUTE 38 STE 21",
"address_2": "LUMBERTON PLAZA",
"city": "LUMBERTON",
"state": "NJ",
"postal_code": "080482987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1636 ROUTE 38 STE 21",
"address_2": "LUMBERTON PLAZA",
"city": "LUMBERTON",
"state": "NJ",
"postal_code": "08048",
"telephone_number": "609-914-5050",
"fax_number": "609-914-5059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NERUGANTI",
"first_name": "PRATHIMA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2018-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "22D102299300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lumberton, NJ
- Mt Holly Eye Physicians & Surgeons Professional Association
- Mt Holly Eye Physicians and Surgeons
- Mt. Holly Family Footcare
- Naomi Myers, LAMFT
- National Mentor Healthcare, LLC (New Jersey MENTOR)
- Neurology Consultants of Burlington County, PA
- New Jersey CVS Pharmacy LLC (CVS Pharmacy #11010)
- Newsome Psychological Services
- Hulon B. Newsome, PSY.D.
- Diana T Noller, P.A., C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2018; 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.