DR. ANAITA NALLADARU MULLASSERIL (NPI# 1053558254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053558254 |
| Entity Type | Individual |
| Full Name | DR. ANAITA NALLADARU MULLASSERIL |
| Credential | B.D.S., M.S. |
| Practice Address |
504 Shawnee Mall Dr Shawnee OK 74804-1317 |
| Practice Telephone | 4058788899 |
| Practice Fax Number | 4058788896 |
| Mailing Telephone | 4058788899 |
| Mailing Fax Number | 4058788896 |
| Enumeration Date | 2009-01-10 |
| Last Update Date | 2012-07-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
172 | OK | Dental Providers |
| Street Address |
504 SHAWNEE MALL DR |
| City | SHAWNEE |
| State | OK |
| Zip Code | 74804-1317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922366475 | Mullasseril PC | Dentist | 504 Shawnee Mall Dr, Shawnee, OK 74804-1317 | 2012-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164063699 | Isaac Benjamin Gray | Student in an Organized Health Care Education/Training Program | 4010 Blaine Road, Shawnee, OK 74804 | 2019-10-06 |
| 1750863775 | Dillon Gibson | Specialist/Technologist | Oklahoma Baptist University, 500 W. University, Shawnee, OK 74804 | 2018-09-06 |
| 1912368242 | Peggy Baker | Occupational Therapist | 7602 N. Kickapoo, Shawnee, OK 74804 | 2016-03-15 |
| 1861731093 | Shariff Mohammed El-assi | Behavioral Analyst | 45 Crown Point, Shawnee, OK 74804 | 2013-02-07 |
| 1902103112 | Action Physical Therapy & Rehabilitation, Pllc | Physical Therapist | 2506 N Harrison, Shawnee, OK 74804 | 2011-02-24 |
| 1639493315 | Oklahoma Em - 1 Medical Services,p.c. | Emergency Medicine | 1102 W.macarthur, Shawnee, OK 74804 | 2010-03-24 |
| 1790989473 | Eastern Oklahoma Radiation Associates, LLC | Radiology | 3700 N Kickapoo Ave Ste 108, Shawnee, OK 74804 | 2007-06-14 |
| 1821210444 | Mickey Sehorn D.d.s., P.C. | Dentist | 1601 Airport Drive, Shawnee, OK 74804 | 2007-05-03 |
| 1760525711 | Leanna Rae Olsen | Registered Nurse | 1500 N. Kickapoo, Suite #4, Shawnee, OK 74804 | 2007-02-15 |
| 1467517920 | Mahmoud Abdel-fattah Khalifa | Pathology | Unity Health Center, 1102 West Macarthur, Shawnee, OK 74804 | 2006-12-26 |
| Find all providers in zip 74804 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942660527 | Kristen M.w. Sander | Dentist | 6804 Silverheel St, Shawnee, KS 66226-5300 | 2016-02-25 |
| 1275921769 | Orthodontic Specialists of Shawnee | Dentist | 18 E Dunloup Rd, Shawnee, OK 74804-3203 | 2015-01-06 |
| 1487882494 | Munisha Nanda | Dentist | 19 W Interstate Pkwy, Shawnee, OK 74804-1331 | 2009-06-29 |
| 1326026477 | Chad Bulleigh | Dentist | 22048 W 66th St, Shawnee, KS 66226-3500 | 2006-01-08 |
| 1356980882 | Kaylee Anne Bergman | Dentist | 6804 Silverheel St, Shawnee, KS 66226-5300 | 2020-01-01 |
| 1659633782 | Angela M Williams | Dentist | 11005 W 60th St, Ste 180, Shawnee, KS 66203-2716 | 2012-06-14 |
| 1922366475 | Mullasseril PC | Dentist | 504 Shawnee Mall Dr, Shawnee, OK 74804-1317 | 2012-05-02 |
| 1073799508 | William Jack Mann | Dentist | 18 E Dunloup, Shawnee, OK 74804-3203 | 2008-01-15 |
| 1588749675 | Robert Wayne Thompson | Dentist | 11005 W 60th St, Suite 180, Shawnee, KS 66203-2913 | 2006-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962013813 | Lake Country Orthodontics | Dentist | 1119 Walnut Dr Ste 4, Ardmore, OK 73401-2360 | 2020-08-13 |
| 1285284919 | Marlo A. Miller Dds, Ms | Dentist | 816 S Mustang Rd, Yukon, OK 73099-6767 | 2019-09-15 |
| 1215480371 | Gabriel Luttrell | Dentist | 421 Nw 10th St, Suite 201-e, Oklahoma City, OK 73103-3909 | 2016-07-25 |
| 1417328170 | Tyler Holt | Dentist | 157 Stonebridge Blvd Apt 2223, Edmond, OK 73013-4773 | 2015-10-07 |
| 1235525734 | Christopher Trockel Orthodontics PC | Dentist | 12345 S Memorial Dr Ste 113, Bixby, OK 74008-2571 | 2015-04-10 |
| 1629474127 | Smile Galaxy Orthodontics | Dentist | 10001 S Pennsylvania Ave Bldg P, Suite #130, Oklahoma City, OK 73159-6923 | 2014-11-10 |
| 1831505999 | Gabriela Restuccia | Dentist | 1201 N Stonewall Ave Rm 449, Oklahoma City, OK 73117-1214 | 2014-07-09 |
| 1962818351 | Dental Depot Orthodontics Sw Okc, Pllc | Dentist | 6217 S Western Ave Ste A, Oklahoma City, OK 73139-1605 | 2014-07-07 |
| 1730502519 | Dental Depot Orthodontics North Okc Pllc | Dentist | 14440 N Penn Ave, Oklahoma City, OK 73134-6003 | 2014-01-29 |
| 1295168284 | Craig & Streight Orthodontics | Dentist | 706 24th Ave Nw, Norman, OK 73069-6232 | 2013-08-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.