Sumitra Yalamanchili, DDS, MPH

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

22DI02289700 Issued in NJ

Practice address

703 Main St
Paterson, NJ 07503-2621

Phone

(973) 754-2050

NPI assigned

Jul 31, 2006

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 15, 2015 through Oct 15, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263859200000",
    "number": "1942216288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 HAMBURG TPKE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "973-754-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YALAMANCHILI",
        "first_name": "SUMITRA",
        "name_prefix": "Dr.",
        "credential": "DDS, MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2010-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "22DI02289700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chen Xia
• Wenlang Xia, M.D.
• Raed Yabroudi
• Yagnam LLC (La Nueva Mercedes Pharmacy)
• Amal Yahya
• Emmanuel Nyaba Yamusah, M.D.
• Franz Shynri Yanagawa, M.D.
• James Yang, DO
• Juliana Patrice Yangco
• Christopher Yap, PHARMD

• Oral and Maxillofacial Surgery (Dentist) in Paterson, NJ
• Providers in Paterson, NJ by specialty
• Oral and Maxillofacial Surgery (Dentist) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2010; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.