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NPI Code Detail

MEDICARE: DR. SUJATHA VEMURI DDS

MEDICARE: DR. SUJATHA VEMURI DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDEN1000463DC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
211640775OTHERCAQH

General Provider Information

NPI Number : 1306909866
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUJATHA VEMURI DDS
Provider Business Mailing Address
First Line : 350 N CLARK ST, STE 600
Second Line : C/O KOS SERVICES
City : CHICAGO
State : IL
Zip : 60654
Country : US
Telephone Number : 703-347-4577
Fax Number :
Provider Business Practice Location Address
First Line : 3925 MINNESOTA AVE NE
Second Line :
City : WASHINGTON
State : DC
Zip : 20019-2662
Country : US
Telephone Number : 703-347-4577
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2006
Last Update Date : 09/26/2013

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