Active NPI
Suneel Kumar Namburi, DMD
- Dentist
- Albuquerque, NM
National Provider Identifier
1811321003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DD4343
- Practice address
- 800 Juan Tabo Blvd NE
Ste Q
Albuquerque, NM 87123-1444 - Phone
- (630) 730-9676
- NPI assigned
- Aug 24, 2013
- Last updated
- Sep 19, 2022
- Sex
- Male
- Sole proprietor
- No
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 | DD4343 | NM | Primary |
Addresses
Primary practice location
800 Juan Tabo Blvd NE
Ste Q
Albuquerque, NM 87123-1444
Mailing address
85 W Hwy 22
Santo Domingo Pueblo, NM 87052
Phone (630) 730-9676
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32284756 | Medicaid | NM | |
| 337266602 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Dental of New Mexico | Dentist | Current | Accepting new patients |
| Apex Dental | Dentist | Current | Accepting new patients |
Locations
800 Juan Tabo Blvd NE
Ste Q
Albuquerque, NM 87123
Phone (505) 554-2262
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dentist
- Albuquerque, NM
- NPI 1396250403
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663545600000",
"number": "1811321003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "85 W HWY 22",
"city": "SANTO DOMINGO PUEBLO",
"state": "NM",
"postal_code": "87052",
"telephone_number": "630-730-9676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 JUAN TABO BLVD NE",
"address_2": "STE Q",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871231444",
"telephone_number": "630-730-9676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAMBURI",
"first_name": "SUNEEL",
"middle_name": "KUMAR",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-24",
"last_updated": "2022-09-19",
"certification_date": "2022-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NM",
"license": "DD4343",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32284756",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "337266602",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.