Samira Mukkamala, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019035526 Issued in IL

Practice address

2119 Clearwater Dr
Oak Brook, IL 60523-8821

Phone

(630) 990-7766

NPI assigned

Apr 10, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Dental Group of Naperville, P.C.

  • Dentist
  • Naperville, IL
  • NPI 1447892047
  NPD
• Dientes Community Dental Care.

  • Dentist
  • Santa Cruz, CA
  • NPI 1437213279
  NPD (past)

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1861187346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28294 FERRY RD APT 271",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605554065",
            "telephone_number": "334-294-2241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2119 CLEARWATER DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238821",
            "telephone_number": "630-990-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKKAMALA",
        "first_name": "SAMIRA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-10",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019035526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriel Mortera, DPT
• Nagla Mostafa, LMFT
• Mount Sinai Hospital
• Caleb E Mowry
• MSK Medical LTD
• Bryan Beranard Mullaney, DNP
• Mullapudi Medical LLC
• Mullapudi Medical LLC
• Mulso Associates Counseling, LTD
• Bryce Mulso

• General Practice Dentistry in Oak Brook, IL
• Providers in Oak Brook, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; 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.

Verify at the official NPI Registry.