MADUGULA PLLC (NPI# 1285978189) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285978189 |
| Entity Type | Organization |
| Organization Name | MADUGULA PLLC |
| Other Organization Name | ASPEN DENTAL |
| Practice Address |
740 Ocean Beach Hwy Ste F Longview WA 98632-4061 |
| Mailing Address |
Po Box 3189 Syracuse NY 13220-3189 |
| Practice Telephone | 3604141400 |
| Practice Fax Number | 3604145223 |
| Mailing Telephone | 3154546000 |
| Mailing Fax Number | 8668034943 |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2012-11-15 |
| Authorized Official Name | DR. KALA MADUGULA (OWNER) |
| Authorized Official Telephone | 3154546000 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 272750 | WA | Dental Providers |
| Other Name | Type Code |
|---|---|
| Aspen Dental | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | MADUGULA PLLC | 7608 Ne 57th Cir, Vancouver, WA 98662-6238 |
| Street Address |
740 OCEAN BEACH HWY STE F |
| City | LONGVIEW |
| State | WA |
| Zip Code | 98632-4061 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992366 | Honor Senior Care LLC | Home Health Aide | 1135 3rd Ave, Ste S101, Longview, WA 98632 | 2020-11-03 |
| 1417416728 | Sam Wise | Dentist | 1538 11th Ave Lowr Columbia, Longview, WA 98632 | 2019-03-16 |
| 1053870717 | Matthew Johnson | Physician Assistant | 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 | 2019-03-12 |
| 1295205367 | Abid Valji | Occupational Therapist | Americana Health and Rehabilitation Center, 917 7th Ave, Longview, WA 98632 | 2018-11-30 |
| 1184106437 | Peacehealth | Durable Medical Equipment & Medical Supplies | Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 | 2018-09-04 |
| 1982186318 | Linda Joan Mason | Licensed Practical Nurse | 1153 23rd Ave, Longview, WA 98632 | 2018-09-01 |
| 1891291910 | Ellen Sumner Hornbeak | Physical Therapist | 200 Triangle Shopping Ctr Ste 270, Longview, WA 98632 | 2018-04-05 |
| 1700399961 | Johnna Joyce Knapp | Speech-Language Pathologist | 2615 Lilac St, Longview, WA 98632 | 2017-11-09 |
| 1841711868 | Deborah Annette Burzynski | Registered Nurse | 1057 12th Avenue, Longview, WA 98632 | 2017-06-29 |
| 1598291122 | Cheyenne West | Counselor | 1616 10th Avenue, Longview, WA 98632 | 2017-05-02 |
| Find all providers in zip 98632 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376011486 | David Matthew Dodge | Dentist | 1461 Broadway Street, Suite A, Longview, WA 98632-3724 | 2018-11-06 |
| 1093293219 | Justin Vanbibber II Dds PC | Dentist | 900 Ocean Beach Hwy Ste A, Longview, WA 98632-4013 | 2018-07-31 |
| 1164977997 | Madison Mack | Dentist | 3008 H G Mosley Pkwy, Longview, TX 75605-2948 | 2016-08-22 |
| 1710360797 | Mohammedreza Atashzareh | Dentist | 1452 Hudson St Ste 200, Longview, WA 98632-3727 | 2015-07-08 |
| 1497197941 | Nicole Dominique Grant | Dentist | 1461 Broadway St Apt A, Longview, WA 98632-3724 | 2013-07-25 |
| 1295177012 | Rishank Reddy Korupolu | Dentist | 3052 N Eastman Rd, Longview, TX 75605-5093 | 2013-07-22 |
| 1205173457 | William G. Lesh Dmd, Ps | Dentist | 950 14th Ave, Longview, WA 98632-2317 | 2013-01-08 |
| 1881930196 | Heartland Dental Care of Texas | Dentist | 3010 H G Mosley Pkwy, Longview, TX 75605-2948 | 2012-12-14 |
| 1629201124 | Thomas Smith Cotton | Dentist | 1405 Mccann Rd, Longview, TX 75601-3852 | 2009-08-31 |
| 1053574319 | Thomas Gilbert Bingham | Dentist | 900 Ocean Beach Hwy Ste 100, Longview, WA 98632-4171 | 2008-07-08 |
| Find all providers in LONGVIEW | ||||
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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.