Individual provider Active NPI

Sravya Maru

  • Dentist
  • Apple Valley, MN
National Provider Identifier
1851071989
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D14979 Issued in MN
Practice address
14929 Florence TRL Ste 200
Apple Valley, MN 55124-4632
Phone
(952) 432-7366
NPI assigned
Jul 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D14979 MN Primary

Addresses

Primary practice location

14929 Florence TRL Ste 200
Apple Valley, MN 55124-4632

Mailing address

14929 Florence TRL Ste 200
Apple Valley, MN 55124-4632
Phone (270) 599-3670

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
D14979MNMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1851071989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14929 FLORENCE TRL STE 200",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551244632",
            "telephone_number": "270-599-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14929 FLORENCE TRL STE 200",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551244632",
            "telephone_number": "952-432-7366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARU",
        "first_name": "SRAVYA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-24",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.