DR. DEEPTHI MUNDRA DDS
NPI 1396006458
Dentist - General Practice in Forest, MS

Q: What is Deepthi Mundra's NPI number?

The NPI number for Deepthi Mundra is 1396006458. It was assigned to this individual provider in the NPPES registry on June 6, 2012.

Q: What is Deepthi Mundra's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Deepthi Mundra was last updated on December 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 06, 2012PECOS Enrolled

SMILE CARE, PLLC, 1237 HIGHWAY 35 S, FOREST, MS 39074(601) 469-8266(601) 469-8294 Get Directions Write a Review

NPPES record last updated: December 7, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 7, 2021, Aug 18, 2021 (2 updates tracked since 2021).

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About Dr. Deepthi Mundra Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DEEPTHI MUNDRA DDS (NPI 1396006458) is an individual general practice provider in Forest, Mississippi, licensed in Wisconsin (6907-15) and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS and maintains a secondary practice location in West Bend.

NPPES Registry Identity

NPI1396006458

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameDR. DEEPTHI MUNDRACredential: DDS

Location AddressSMILE CARE, PLLC, 1237 HIGHWAY 35 SForest, MS 39074-8830

Mailing Address102 Chilton PlMadison, MS 39110-7810 · (773) 844-3439

Phone(601) 469-8266

Fax(601) 469-8294

Sole ProprietorYes

Enumeration DateJune 6, 2012

Last NPPES UpdateDecember 7, 20212 updates tracked since enumeration

NPPES CertifiedDecember 7, 2021

✔ NPI 1396006458 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in WI · 6907-15

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

SMILE CARE, PLLC, Forest, MS 39074

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Secondary Practice Location 1

Location 11721 S Main StWest Bend, WI 53095-4937 · Phone (262) 346-2020

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Deepthi Mundra Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Deepthi Mundra reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Quentin N Burdick Comprehensive Health Care Facility

1,253 mi

Rural

1300 HOSPITAL LOOP
Belcourt, ND 58316

Reassigned Medicare billing, Texas enrollment
193 clinicians in this Medicare group

NPI 1952346934 (701) 477-6111

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39074 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$64.96 typical visit price

range $16.15 – $129.61

Typical copayment $16.24 (range $4.03 – $32.40)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Deepthi Mundra's NPI number?

The NPI number for Deepthi Mundra is 1396006458. It was assigned to this individual provider in the NPPES registry on June 6, 2012.

Where is Deepthi Mundra located?

Deepthi Mundra practices at Smile Care, PLLC 1237 Highway 35 S, Forest, MS 39074. The listed phone number is (601) 469-8266.

What is Deepthi Mundra's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Deepthi Mundra enrolled in Medicare?

Yes. Deepthi Mundra is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Deepthi Mundra's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Deepthi Mundra reassigns Medicare benefits to Quentin N Burdick Comprehensive Health Care Facility (Belcourt, ND). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Deepthi Mundra's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Deepthi Mundra accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 11 other insurers list Deepthi Mundra as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Deepthi Mundra was last updated on December 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.