Healthy Dental of Eastern Avenue LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

HEALTHY DENTAL OF EASTERN AVENUE LLC

Practice address

7422 Eastern Ave
Baltimore, MD 21224-1923

Phone

(410) 888-0888

NPI assigned

Nov 2, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Madhu Venkata Rama Raju Nadimpalli, DDS, MPA

Title

General Dentist / Owner

Phone

(201) 257-7095

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667347200000",
    "number": "1932816501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12233 HAYLAND FARM WAY",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210426027",
            "telephone_number": "201-257-7095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7422 EASTERN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212241923",
            "telephone_number": "410-888-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY DENTAL OF EASTERN AVENUE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-02",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A",
        "authorized_official_last_name": "NADIMPALLI",
        "authorized_official_first_name": "MADHU VENKATA",
        "authorized_official_middle_name": "RAMA RAJU",
        "authorized_official_title_or_position": "GENERAL DENTIST / OWNER",
        "authorized_official_telephone_number": "201-257-7095",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MPA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Baltimore, MD
• Providers in Baltimore, MD by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; 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.