Individual provider Active NPI

Saraswathi S Hanumanthegowda, DDS

  • Dentist
  • Redmond, WA
National Provider Identifier
1962836304
Registry record updated Aug 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE.60390122 Issued in WA
Practice address
15230 NE 24TH St Ste N
Redmond, WA 98052-5540
Phone
(425) 786-5363
NPI assigned
Aug 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE.60390122 WA Primary

Addresses

Primary practice location

15230 NE 24TH St Ste N
Redmond, WA 98052-5540

Mailing address

15230 NE 24TH St Ste N
Redmond, WA 98052-5540
Phone (425) 786-5363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150804005898 CA Order and Referring Only - DentistPractitioner - Dentist 3678887668

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE.60390122WAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1962836304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15230 NE 24TH ST STE N",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525540",
            "telephone_number": "425-786-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15230 NE 24TH ST STE N",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525540",
            "telephone_number": "425-786-5363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANUMANTHEGOWDA",
        "first_name": "SARASWATHI",
        "middle_name": "S",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-21",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE.60390122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

Verify at the official NPI Registry.