Suveetha Mikkili, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2009014618 Issued in MO

Practice address

131 W Monroe Ave Ste 3
Kirkwood, MO 63122-5814

Phone

(314) 821-1496

Fax

(314) 822-8487

NPI assigned

Sep 11, 2009

Last updated

Nov 23, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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 MO

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

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

{
    "created_epoch": "1252627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763856000000",
    "number": "1861725616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 W MONROE AVE STE 3",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631225814",
            "telephone_number": "314-821-1496",
            "fax_number": "314-822-8487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 W MONROE AVE STE 3",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631225814",
            "telephone_number": "314-821-1496",
            "fax_number": "314-822-8487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKKILI",
        "first_name": "SUVEETHA",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-11",
        "last_updated": "2025-11-23",
        "certification_date": "2025-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2009014618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Kirkwood, MO
• Providers in Kirkwood, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.