Individual provider Active NPI

Sunil Kumar Ilapogu, DDS

  • Pediatric Dentistry
  • Ventura, CA
National Provider Identifier
1811921869
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
49762 Issued in CA
Practice address
789 S Victoria Ave Ste 206
Ventura, CA 93003-9078
Phone
(805) 644-5516
Fax
(805) 644-4124
NPI assigned
Jul 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 49762 CA Primary

Addresses

Primary practice location

789 S Victoria Ave Ste 206
Ventura, CA 93003-9078

Mailing address

789 S Victoria Ave Ste 206
Ventura, CA 93003-9078
Phone (805) 644-5516

Other identifiers 1

IdentifierTypeStateIssuer
B49762-01OtherCAHEALTHY FAMILIES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
49762CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811921869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 S VICTORIA AVE STE 206",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930039078",
            "telephone_number": "805-644-5516",
            "fax_number": "805-644-4124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 S VICTORIA AVE STE 206",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930039078",
            "telephone_number": "805-644-5516",
            "fax_number": "805-644-4124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILAPOGU",
        "first_name": "SUNIL",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "49762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY FAMILIES",
            "identifier": "B49762-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.