DR. SUPRAJA MUNDLA DMD
NPI 1770637688
Dentist - General Practice in Canton, MI
About Dr. Supraja Mundla Dmd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. SUPRAJA MUNDLA DMD (NPI 1770637688) is an individual general practice provider in Canton, Michigan, licensed in Michigan (2901018754) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Supraja Mundla Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 48187 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Supraja Mundla's NPI number?
The NPI number for Supraja Mundla is 1770637688. It was assigned to this individual provider in the NPPES registry on January 22, 2007.
Where is Supraja Mundla located?
Supraja Mundla practices at 5970 N Lilley Rd, Canton, MI 48187. The listed phone number is (734) 981-5455.
What is Supraja Mundla's specialty?
The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.
Is Supraja Mundla enrolled in Medicare?
Yes. Supraja Mundla is registered in the Medicare PECOS enrollment system.
What insurance does Supraja Mundla accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Cross Blue Shield of Michigan Mutual Insurance Company and Blue Cross and Blue Shield of Alabama and 10 other insurers list Supraja Mundla 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 Supraja Mundla was last updated on January 21, 2022. 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.
# Dr. Supraja Mundla, DMD · NPI 1770637688
General Practice provider in Canton, Michigan. Individual provider, active in the CMS NPPES registry since January 22, 2007.
## Identity
- **NPI:** 1770637688 (Entity type: Individual)
- **Enumerated:** January 22, 2007
- **Primary specialty:** Dentist - General Practice · taxonomy 1223G0001X
- **State license:** 2901018754 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 5970 N LILLEY RD, Canton, MI 48187-3625
- **Phone:** (734) 981-5455
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
## Record status
- **NPPES last updated:** January 21, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1770637688) · Data from the CMS NPPES public registry.