Susmitha Aluru, DMD

Individual provider Active NPI Dentist · Hutto, TX

NPI 1912095928 · NPPES record last updated Feb 25, 2014

Key facts

NPI
1912095928
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
24400 (TX)
Practice address
409 W Front St
Suite#250
Hutto, TX 78634-4204
Phone
(512) 642-6109
Fax
(512) 642-6194
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
24400TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Susmitha Aluru, PLLC Pediatric Dentistry Current Accepting new patients

Locations

409 W Front St
Ste 250
Hutto, TX 78634
Phone (512) 642-6109

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 24400 TX
Dentist 122300000X 24400 TX Yes

Addresses

Primary practice location

409 W Front St
Suite#250
Hutto, TX 78634-4204

Mailing address

409 W Front St
Suite#250
Hutto, TX 78634-4204
Phone (512) 642-6109

Other identifiers

IdentifierTypeStateIssuer
49682253MedicaidCO
1758590OtherCOUNITED CONCORDIA

Other providers in Hutto, TX

All providers in Hutto, TX · Dentist in Texas

Sources for this page

Verify at the official NPI Registry.