Active NPI
Anitha Tetali, DDS
- Dentist
- Frisco, TX
National Provider Identifier
1841673746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 31871
- Practice address
- 15950 Eldorado Pkwy
Suite # 100
Frisco, TX 75035-5802 - Phone
- (972) 540-9977
- NPI assigned
- Jul 9, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 31871 | TX | Primary |
| Dentist | 122300000X | DN21269 | FL |
Addresses
Primary practice location
15950 Eldorado Pkwy
Suite # 100
Frisco, TX 75035-5802
Mailing address
15950 Eldorado Pkwy
Suite # 100
Frisco, TX 75035-5802
Phone (972) 540-9977
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN21269 | FL | MD | Dentist |
| 31871 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frisco Custer Star Dental Group, PC | 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Frisco, TX
- NPI 1245532688
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471392000000",
"number": "1841673746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15950 ELDORADO PKWY",
"address_2": "SUITE # 100",
"city": "FRISCO",
"state": "TX",
"postal_code": "750355802",
"telephone_number": "972-540-9977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15950 ELDORADO PKWY",
"address_2": "SUITE # 100",
"city": "FRISCO",
"state": "TX",
"postal_code": "750355802",
"telephone_number": "972-540-9977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TETALI",
"first_name": "ANITHA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-09",
"last_updated": "2016-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "31871",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN21269",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Frisco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.