SUSMITHA RAO KOTI (NPI# 1578878435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578878435 |
| Entity Type | Individual |
| Full Name | SUSMITHA RAO KOTI |
| Credential | DDS |
| Practice Address |
1740 W 17th Ave Eugene OR 97402-3619 |
| Mailing Address |
1090 Northchase Pkwy Se Suite 290 Marietta GA 30067-6405 |
| Practice Telephone | 4582103543 |
| Mailing Telephone | 6789045665 |
| Enumeration Date | 2010-08-16 |
| Last Update Date | 2020-08-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
27635 | TX | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
DN014164 | GA | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
D11308 | OR | Dental Providers |
| Street Address |
1740 W 17TH AVE |
| City | EUGENE |
| State | OR |
| Zip Code | 97402-3619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427031350 | Hayden Family Dental Group | Dentist | 1740 W 17th Ave, Eugene, OR 97402-3619 | 2005-11-23 |
| 1437762473 | Vy Thanh Tran | Dentist | 1740 W 17th Ave, Eugene, OR 97402-3619 | 2020-08-28 |
| 1194369801 | Anastasia Mospanova | Dentist | 1740 W 17th Ave, Eugene, OR 97402-3619 | 2019-11-05 |
| 1134773724 | Austin Irene Lundin | Dentist | 1740 W 17th Ave, Eugene, OR 97402-3619 | 2019-07-31 |
| 1356995260 | Casey A Thein | Dentist | 1740 W 17th Ave, Eugene, OR 97402-3619 | 2019-07-29 |
| 1710431093 | Alexander Sonesson | Dentist | 1740 W 17th Ave, Eugene, OR 97402-3619 | 2016-08-04 |
| 1386197564 | Erin Kathleen Johnson | Dentist | 1740 W 17th Ave, Eugene, OR 97402-3619 | 2016-07-25 |
| 1417321449 | Lauri Michelle Peckels | Dental Hygienist | 1740 W 17th Ave, Eugene, OR 97402-3619 | 2015-11-13 |
| 1639586340 | Tyler Schultze | Dentist | 1740 W 17th Ave, Eugene, OR 97402-3619 | 2014-07-14 |
| 1356756001 | Dana Matlock | Dentist | 1740 W 17th Ave, Eugene, OR 97402-3619 | 2014-06-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538709704 | Jordan Charles Smith | Massage Therapist | 775 Menroe St., Eugene, OR 97402 | 2020-01-15 |
| 1104462134 | Cerridwen Laurel Martin | Massage Therapist | 775 Monroe St., Eugene, OR 97402 | 2019-11-25 |
| 1720556368 | Valerie Jeanne Charles | Massage Therapist | 989 Throne Dr., Eugene, OR 97402 | 2018-11-12 |
| 1407324189 | Laura Angulo | Massage Therapist | 1247 W 8th Ave Apt 10, Eugene, OR 97402 | 2018-11-11 |
| 1932687472 | Karl Alan Porter | Counselor | 1195 City View St Ste B, Eugene, OR 97402 | 2018-08-06 |
| 1992283170 | Fresenius Medical Care Dialysis Services - Oregon, LLC | Clinic/Center | 3747 W 11th Ave, Eugene, OR 97402 | 2018-07-31 |
| 1699251744 | Isabella Arlo Jane Silver | Counselor | 970 W 7th Ave., Eugene, OR 97402 | 2018-07-12 |
| 1447740527 | Shasta Tobi Cooke | Behavioral Analyst | 677 1/2 W 12th Ave, Eugene, OR 97402 | 2018-05-15 |
| 1497205306 | Jenna Bracco | Social Worker | 1274 W. 7th Avenue Suite 201, Eugene, OR 97402 | 2016-10-04 |
| 1871041392 | Jeremy Powers | Massage Therapist | 882 Van Buren St, Eugene, OR 97402 | 2016-09-13 |
| Find all providers in zip 97402 | ||||
| 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 |
|---|---|---|---|---|
| 1588297279 | Dennis M Dunne Dds PC | Dentist | 1600 Executive Pkwy Ste 350, Eugene, OR 97401-7110 | 2020-02-20 |
| 1114493582 | Matt W Anderson Dds PC | Dentist | 2215 Willamette St Ste A, Eugene, OR 97405-3341 | 2018-10-23 |
| 1366738858 | Eugene Kids' Dentist, LLC | Dentist | 4122 Quest Dr., Eugene, OR 97402 | 2011-06-22 |
| 1396067955 | James Edward Barta | Dentist | 2215 Willamette St, Suite A, Eugene, OR 97405-2847 | 2010-02-24 |
| 1184855967 | Timothy Richardson | Dentist | 4122 Quest Dr, Eugene, OR 97402-8768 | 2009-07-28 |
| 1427271923 | Katrina J. Drew | Dentist | 748 Goodpasture Island Road, Eugene, OR 97401 | 2007-04-11 |
| 1801902101 | Dentistry for Children Nw LLC | Dentist | 2215 Willamette St A, Eugene, OR 97405 | 2006-08-21 |
| 1144255043 | Dennis M Dunne | Dentist | 1600 Executive Pkwy, Suite 350, Eugene, OR 97401-2138 | 2006-07-11 |
| 1013567080 | Katrina J Drew, Dds, PC | Dentist | 748 Goodpasture Island Road, Eugene, OR 97401 | 2019-09-12 |
| 1366836835 | Tyler Brent Whiting | Dentist | 4122 Quest Dr, Eugene, OR 97402 | 2015-03-23 |
| Find all providers in EUGENE | ||||
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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.