Praveen Pavuluru, DMD, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PRAVEEN PAVULURU, DMD, LLC

Doing business as

Carefirst Dental Clinic

Practice address

90 Ridgewood Dr
Bangor, ME 04401-2652

Phone

(207) 262-3744

Fax

(207) 262-3745

NPI assigned

Jun 23, 2022

Last updated

Jun 23, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Praveen K Pavuluru, DMDNPI 1467548552

Title

Sole Owner/Member

Phone

(207) 577-3424

Specialties & licenses 1

Addresses

Other names 1

• Carefirst Dental Clinic Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Praveen Kumar Pavuluru, D.M.D

  • General Practice Dentistry
  • Bangor, ME
  • NPI 1467548552
  NPD Authorized official

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655942400000",
    "number": "1962133454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 RIDGEWOOD DR",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044012652",
            "telephone_number": "207-262-3744",
            "fax_number": "207-262-3745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 RIDGEWOOD DR",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044012652",
            "telephone_number": "207-262-3744",
            "fax_number": "207-262-3745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAVEEN PAVULURU, DMD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A",
        "authorized_official_last_name": "PAVULURU",
        "authorized_official_first_name": "PRAVEEN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SOLE OWNER/MEMBER",
        "authorized_official_telephone_number": "207-577-3424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carefirst Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gloria J Powell, MA
• Jacob Lee Powell
• Savanna Rae Power
• Annie E Powers, MD
• Kari Powers, CRNA
• Premier Medical Services
• Amanda Vanessa Prescott, LMSW-CC
• David Prescott, PHD
• Tiffany Presnell, LCSW
• Sarah Anne Pressley, AG-ACNP

• Dental Clinic/Center in Bangor, ME
• Providers in Bangor, ME by specialty
• Dental Clinic/Center in Maine

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