MADUGULA LLC (NPI# 1760727234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760727234 |
| Entity Type | Organization |
| Organization Name | MADUGULA LLC |
| Other Organization Name | ASPEN DENTAL |
| Practice Address |
2235 Nw Town Center Dr Beaverton OR 97006 |
| Mailing Address |
Po Box 3189 Syracuse NY 13220-3189 |
| Practice Telephone | 5032070510 |
| Practice Fax Number | 5034663975 |
| Mailing Telephone | 3154546000 |
| Mailing Fax Number | 8668034943 |
| Enumeration Date | 2012-12-10 |
| Last Update Date | 2012-12-10 |
| Authorized Official Name | DR. KALA SAGAR 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 | 9735 | OR | Dental Providers |
| Other Name | Type Code |
|---|---|
| Aspen Dental | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | MADUGULA LLC | 2235 Nw Town Center Drive, Beaverton, OR 97006 |
| Street Address |
2235 NW TOWN CENTER DR |
| City | BEAVERTON |
| State | OR |
| Zip Code | 97006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184238727 | Hayden Alexander Meriwether | Dentist | 17895 Ne Evergreen Pkwy, #100, Beaverton, OR 97006 | 2020-09-01 |
| 1336781202 | Courtney Rae Murata | Behavior Technician | 337 Nw 215th Terrace, Apt, 106, Hillsboro, OR 97006 | 2019-10-11 |
| 1992355986 | Pamela J. Viado | Technician | 1220 Nw Weybridge Way, Beaverton, OR 97006 | 2019-09-12 |
| 1477115384 | One Change Group | Community/Behavioral Health | 2499 Nw 206th Ave, Apt A233, Hillsboro, OR 97006 | 2019-07-01 |
| 1649731332 | Regina C. Rizo | Social Worker | 1925 Amberglen Parkway, #3a-131, Hillsboro, OR 97006 | 2019-03-26 |
| 1043731912 | Elizabeth A Cintron | Occupational Therapy Assistant | 1189 Ne 89th Ave Apt 305, Hillsboro, OR 97006 | 2017-06-30 |
| 1265979173 | Lindsay Jensen | Massage Therapist | 15220 Nw Greenbrier Pkwy Ste 260, Beaverton, OR 97006 | 2017-01-30 |
| 1851835722 | Changepoint, Inc | Clinic/Center | 1700 Nw 167th Place, Suite 240, Beaverton, OR 97006 | 2016-12-13 |
| 1689126302 | Occupational Health Centers of The Southwest, P.a. (tx) | Clinic/Center | 2225 Nw Towncenter Drive, Beaverton, OR 97006 | 2016-10-28 |
| 1558717413 | Dillon Duvall | Physical Therapist | 16895 Nw Cornell Rd, #110, Beaverton, OR 97006 | 2016-05-10 |
| Find all providers in zip 97006 | ||||
| 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 |
|---|---|---|---|---|
| 1184238727 | Hayden Alexander Meriwether | Dentist | 17895 Ne Evergreen Pkwy, #100, Beaverton, OR 97006 | 2020-09-01 |
| 1235662131 | Mishaun Sahebi | Dentist | 10320 Sw Mockingbird Way, Beaverton, OR 97007-6176 | 2017-04-07 |
| 1114478971 | Jun Hyug Choi | Dentist | 5055 Sw 160th Ave, Beaverton, OR 97007-2614 | 2016-10-17 |
| 1821348889 | Aaron Lloyd Pogue | Dentist | 17203 Sw Baseline Rd, Beaverton, OR 97006-4253 | 2012-09-17 |
| 1295083111 | Carolyn Choi | Dentist | 12600 Sw Crescent St Ste 106, Beaverton, OR 97005 | 2012-08-27 |
| 1134439144 | Mira Kharoti Della Croce | Dentist | 1791 Nw 173rd Ave Ste 110, Beaverton, OR 97006-5630 | 2010-10-13 |
| 1205145489 | Joshua Kim | Dentist | 10773 Sw Beaverton Hillsdale Hwy Ste B, Beaverton, OR 97005-3010 | 2010-10-05 |
| 1528377546 | John Neil Della Croce | Dentist | 8070 Sw Hall Blvd Ste 200, Beaverton, OR 97008-6419 | 2010-09-27 |
| 1306150768 | Christopher L Flemming | Dentist | 4925 Sw Griffith Drive, Beaverton, OR 97005-0000 | 2010-07-27 |
| 1578884912 | Michael Joseph Isaac | Dentist | 8660 Sw Scholls Ferry Road, Beaverton, OR 97008 | 2010-06-21 |
| Find all providers in BEAVERTON | ||||
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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.