Individual provider Active NPI

Prathima Krishna Adusumilli, D.M.D, M.S

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Coral Springs, FL
National Provider Identifier
1891096533
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DN18968 Issued in FL
Practice address
11330 Wiles Rd
Coral Springs, FL 33076-2113
Phone
(954) 418-2354
Fax
(854) 369-1440
NPI assigned
Nov 11, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DN18968 FL Primary

Addresses

Primary practice location

11330 Wiles Rd
Coral Springs, FL 33076-2113

Mailing address

11330 Wiles Rd
Coral Springs, FL 33076-2113
Phone (954) 418-2354

Other practice location 1

11332 Wiles Rd
Coral Springs, FL 33076-2114
Phone (954) 642-1013

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DN18968FLMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Braces Guru PLLC Orthodontics and Dentofacial Orthopedics Current Accepting new patients
Coral Dental Specialists LLC Orthodontics and Dentofacial Orthopedics Current Accepting new patients

Locations

11332 Wiles Rd
Coral Springs, FL 33076
Phone (954) 418-2354

11330 Wiles Rd
Coral Springs, FL 33076
Phone (954) 418-2354

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1289433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1891096533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11330 WILES RD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330762113",
            "telephone_number": "954-418-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11330 WILES RD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330762113",
            "telephone_number": "954-418-2354",
            "fax_number": "854-369-1440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11332 Wiles Rd",
            "address_purpose": "LOCATION",
            "city": "Coral Springs",
            "state": "FL",
            "postal_code": "330762114",
            "country_code": "US",
            "telephone_number": "954-642-1013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADUSUMILLI",
        "first_name": "PRATHIMA",
        "middle_name": "KRISHNA",
        "name_prefix": "Dr.",
        "credential": "D.M.D, M.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-11",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN18968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; 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.