DR. SHARAVANA KUMAR GAJAPATHI (NPI# 1407045735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407045735 |
| Entity Type | Individual |
| Full Name | DR. SHARAVANA KUMAR GAJAPATHI |
| Credential | D.D.S, M.P.H |
| Practice Address |
1115 Us Highway 259 S Henderson TX 75654-3629 |
| Practice Telephone | 9033928251 |
| Mailing Telephone | 9033928251 |
| Mailing Fax Number | 9033928207 |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2020-07-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 24289 | TX | Dental Providers |
| N | 122300000X | Dentist | D12360 | MN | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
24289 | TX | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 203375501 | 05 | |
| TX | 206661513 | 05 |
| Street Address |
1115 US HIGHWAY 259 S |
| City | HENDERSON |
| State | TX |
| Zip Code | 75654-3629 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295920957 | Robert Joseph Griffith | Nurse Practitioner | 1115 Us Highway 259 S, Henderson, TX 75654-3629 | 2007-09-06 |
| 1518443324 | Amsale Derese | Dentist | 1115 Us Highway 259 S, Henderson, TX 75654-3629 | 2018-07-15 |
| 1861905523 | Brenda S Fountain | Nurse Practitioner | 1115 Us Highway 259 S, Henderson, TX 75654 | 2017-11-15 |
| 1891046801 | Brooke Suzan Martin | Nurse Practitioner | 1115 Us Highway 259 S, Henderson, TX 75654-3629 | 2012-10-01 |
| 1851611503 | Judith Denise Sutherland | Social Worker | 1115 Us Highway 259 S, Henderson, TX 75654-3629 | 2010-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124657689 | Danielle Villanueva | Lactation Consultant, Non-RN | 502 Smith Street, Henderson, TX 75654 | 2020-04-06 |
| 1194374488 | Peggie Foreman | Technician | 6984 7.m. 13 W, Henderson, TX 75654 | 2019-09-09 |
| 1174086714 | Kc Creek Equestrian, LLC | Psychologist | 9906 Cr 468 W, Henderson, TX 75654 | 2019-04-10 |
| 1639529753 | J.l. Miguez, Inc. | Hearing Aid Equipment | 522 Us Hwy 79 South, Suite B, Henderson, TX 75654 | 2016-06-20 |
| 1073940227 | Amberly Hopson | Nurse Practitioner | 1115 U.S. 259, Henderson, TX 75654 | 2013-10-02 |
| 1790002632 | Chris Cummings | Marriage & Family Therapist | 1048 County Road 306d, Henderson, TX 75654 | 2010-05-03 |
| 1649412354 | Mt. Enterprise Community Health Clinic | Clinic/Center | 1115 Highway 259 South, Henderson, TX 75654 | 2009-03-26 |
| 1861678146 | Crystal Cloutier | Occupational Therapy Assistant | 2009 Price St, Henderson, TX 75654 | 2008-01-16 |
| 1477739225 | Wcg Henderson Home Health Care Supply LLC | Durable Medical Equipment & Medical Supplies | 702 Fair Park Dr., Suite 103, Henderson, TX 75654 | 2008-01-10 |
| 1316127806 | Advancing At Home Health Care LLC | Home Health | 702 Fair Park Dr, Suite 101, Henderson, TX 75654 | 2007-11-13 |
| Find all providers in zip 75654 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326537028 | Henderson Pediatric Dentistry PC | Dentist | 390 N Stephanie St Ste 104, Henderson, NV 89014-8029 | 2018-05-08 |
| 1457703290 | Wesley Archer | Dentist | 10400 S Eastern Ave, Henderson, NV 89052-3957 | 2016-07-05 |
| 1962843961 | Manny Rapp | Dentist | 1701 N. Green Valley Pkwy #8e, Henderson, NV 89074 | 2013-07-08 |
| 1699074112 | Rhonda L Kearney, Dds, Ms, Pllc | Dentist | 451 Ruin Creek Rd., 205, Henderson, NC 27536-0000 | 2011-03-23 |
| 1740485846 | Rhonda Louise Kearney | Dentist | 451 Ruin Creek Rd Ste 205, Henderson, NC 27536-5920 | 2007-06-19 |
| 1871702076 | Mark Clayton Peterson | Dentist | 1600 W Sunset Rd Ste B, Henderson, NV 89014-2655 | 2007-05-22 |
| 1003939810 | Daniel William Sims Professional Corporation | Dentist | 375 N Stephanie St Bldg 6, Suite 611, Henderson, NV 89014-8771 | 2007-04-08 |
| 1841392172 | Chad W. Ellsworth | Dentist | 2843 St. Rose Pkwy, Suite 100, Henderson, NV 89052 | 2006-09-05 |
| 1740391465 | Laurence Jay Levine | Dentist | 2610 W Horizon Ridge Pkwy Ste 202, Henderson, NV 89052-2870 | 2006-08-31 |
| 1912924820 | Adaven Childrens Dentistry | Dentist | 1701 N Green Valley Parkway, #8e, Henderson, NV 89074 | 2006-07-16 |
| Find all providers in HENDERSON | ||||
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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.