Nagashree Balur Prakash, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD3275 Issued in NM

Practice address

1217 1St St NW
Albuquerque, NM 87102-1529

Phone

(505) 766-5197

NPI assigned

Jun 26, 2008

Last updated

Jul 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Prakash Dentistry, LLC

  • Dentist
  • Albuquerque, NM
  • NPI 1407370018
  NPD Authorized official
• Bella Smiles Inc

  • General Practice Dentistry
  • Albuquerque, NM
  • NPI 1720117062
  NPD (past)
• Comfortable Dentistry 4U LLC

  • Dentist
  • Albuquerque, NM
  • NPI 1679050942
  NPD (past)

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1811159247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9204 MENAUL BLVD NE STE 3",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871122201",
            "telephone_number": "505-299-6112",
            "fax_number": "505-299-7718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 1ST ST NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021529",
            "telephone_number": "505-766-5197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRAKASH",
        "first_name": "NAGASHREE",
        "middle_name": "BALUR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54839",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD3275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52932532",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssa D Prado, OTD
• Lydia Esther Prado, M.D.
• Kim Raleigh Prairie, CNM
• Regina Prairie
• Prakash Dentistry, LLC
• Gary D Prant, DPM
• Surasri Prapasiri, M.D.
• Haley Elizabeth Jessica Prather
• Katelyn N Pratico Weatherred, LMHC, CSW
• Heather A Pratt-Chavez, MD

• General Practice Dentistry in Albuquerque, NM
• Providers in Albuquerque, 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 Jul 22, 2020; 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.