Individual provider Active NPI

Manjula Battaluri, D.M.D

  • General Practice Dentistry
  • Pepperell, MA
National Provider Identifier
1972713600
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19616 Issued in MA
Practice address
11 Main Street
Pepperell, MA 01463
Phone
(978) 433-6344
Fax
(978) 433-5975
NPI assigned
May 23, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 19616 MA Primary

Addresses

Primary practice location

11 Main Street
Pepperell, MA 01463

Mailing address

P O Box 274
Pepperell, MA 01463
Phone (978) 433-6344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20161202000446 MA Order and Referring Only - Oral SurgeryPractitioner - DentistPractitioner - Oral Surgery 5092095398

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19616MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sai Dental PC General Practice Past Accepting new patients
Pearl Dental Center PC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972713600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 274",
            "city": "PEPPERELL",
            "state": "MA",
            "postal_code": "01463",
            "telephone_number": "978-433-6344",
            "fax_number": "978-433-5975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MAIN STREET",
            "city": "PEPPERELL",
            "state": "MA",
            "postal_code": "01463",
            "telephone_number": "978-433-6344",
            "fax_number": "978-433-5975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATTALURI",
        "first_name": "MANJULA",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "19616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pepperell, MA

Sources for this page

Verify at the official NPI Registry.