AVANTHI KOPURI, DMD, MSD, MHA, PLLC (NPI# 1629617154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629617154 |
| Entity Type | Organization |
| Organization Name | AVANTHI KOPURI, DMD, MSD, MHA, PLLC |
| Practice Address |
2555 W New Haven Ave Melbourne FL 32904-3701 |
| Mailing Address |
10322 Kensington Shore Dr Orlando FL 32827-7307 |
| Practice Telephone | 3217289999 |
| Practice Fax Number | 3217285925 |
| Mailing Telephone | 3057884415 |
| Enumeration Date | 2020-01-01 |
| Last Update Date | 2020-01-01 |
| Authorized Official Name | DR. AVANTHI KOPURI (PRESIDENT) |
| Authorized Official Telephone | 3057884415 |
| Authorized Official Credential | DMD, MSD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Central Florida Orthodontic Specialists | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3010 S Fiske Blvd, Rockledge, FL 329554302 | 3216384455 | |
| 730 Sand Lake Rd Ste 124, Orlando, FL 328097747 | 4078502355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861896474 | Avanthi Kopuri, Dmd, Msd, Mha, Pllc | Dentist | 3010 S Fiske Blvd, Rockledge, FL 32955-4302 | 2014-10-13 |
| 1689798142 | Avanthi Kopuri, Dmd, Msd, Mha, Pllc | Dentist | 730 Sand Lake Rd, Suite 124, Orlando, FL 32809-7750 | 2007-03-19 |
| 1649309071 | Avanthi Kopuri, Dmd, Msd, Mha, Pllc | Dentist | 2555 W New Haven Ave, Melbourne, FL 32904-3701 | 2007-03-02 |
| Street Address |
2555 W NEW HAVEN AVE |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32904-3701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770612285 | Nageswara Rao Kopuri | Dentist | 2555 W New Haven Ave, Melbourne, FL 32904-3701 | 2007-03-02 |
| 1699176990 | Avanthi Kopuri | Dentist | 2555 W New Haven Ave, Melbourne, FL 32904-3701 | 2014-09-06 |
| 1649309071 | Avanthi Kopuri, Dmd, Msd, Mha, Pllc | Dentist | 2555 W New Haven Ave, Melbourne, FL 32904-3701 | 2007-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063066512 | Shepherd's Heart Ministries | Counselor | 900 S Wickham Rd, Melbourne, FL 32904 | 2019-08-01 |
| 1588138663 | Nicholle C Rothengass | Physician Assistant | 2263 W New Haven Ave # 350, W Melbourne, FL 32904 | 2019-01-11 |
| 1114407020 | Natalie Havkin | Speech-Language Pathologist | 250 S Wickham Rd., Melbourne, FL 32904 | 2018-08-20 |
| 1184119299 | Marni B Simon | Speech-Language Pathologist | 565 Acacia Ave, Melbourne Village, FL 32904 | 2018-06-30 |
| 1821588625 | Walden Psychological Services, LLC | Psychologist | 3400 Willowwood Dr, Melbourne, FL 32904 | 2018-05-16 |
| 1598276271 | Donetta Gwin Reynolds | Early Intervention Provider Agency | 764 Triples Crown Lane, West Melbourne, FL 32904 | 2017-10-20 |
| 1598205221 | Marathon Health, LLC | General Practice | 2550 Wingate Boulevard, C/o Brevard Wellcare- South, West Melbourne, FL 32904 | 2017-02-28 |
| 1366875387 | Cancer Center of Melbourne LLC | Clinic/Center | 415 S. Wickham Rd., Melbourne, FL 32904 | 2013-08-13 |
| 1558704312 | Sandra Suzanne Borthwick | Social Worker | 569 Sylvia Rd, Melbourne, FL 32904 | 2013-04-11 |
| 1396983607 | Genesis | Skilled Nursing Facility | 2653 Reflections Pl, W. Melbourne, FL 32904 | 2009-01-23 |
| Find all providers in zip 32904 | ||||
| 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 |
|---|---|---|---|---|
| 1093243917 | Stephen T. Ruso, D.d.s., M.s., P.l.l.c. | Dentist | 3760 N Wickham Rd Ste 1, Melbourne, FL 32935-2326 | 2017-05-23 |
| 1154614493 | Mark Stewart | Dentist | 22 Nelson Ave, Melbourne, FL 32935-6744 | 2011-05-19 |
| 1609091487 | Teresa K Brigance | Dentist | 3760 N Wickham Rd, #1, Melbourne, FL 32935 | 2007-04-16 |
| 1770612285 | Nageswara Rao Kopuri | Dentist | 2555 W New Haven Ave, Melbourne, FL 32904-3701 | 2007-03-02 |
| 1699176990 | Avanthi Kopuri | Dentist | 2555 W New Haven Ave, Melbourne, FL 32904-3701 | 2014-09-06 |
| 1164856233 | Sleep Disorder Specialists Pllc | Dentist | 655 S Apollo Blvd, Suite 1, Melbourne, FL 32901-1485 | 2013-08-26 |
| 1982973939 | Chad R Reddick | Dentist | 22 Nelson Ave, Melbourne, FL 32935-6744 | 2011-12-20 |
| 1649309071 | Avanthi Kopuri, Dmd, Msd, Mha, Pllc | Dentist | 2555 W New Haven Ave, Melbourne, FL 32904-3701 | 2007-03-02 |
| 1073607057 | Joe M Creel, Dds, Pa | Dentist | 100 W New Haven Ave, Melbourne, FL 32901-4303 | 2006-10-03 |
| 1699888214 | Joe Morton Creel | Dentist | 100 W New Haven Ave, Melbourne, FL 32901-4303 | 2006-08-16 |
| Find all providers in MELBOURNE | ||||
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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.