Dr Preethi Kuknooru, DDS is a medicare enrolled "Dentist" provider in Shavano Park, Texas. Her current practice location is
4450 Lockhill Selma Rd Ste 101, Shavano Park, Texas. You can reach out to her office (for appointments etc.) via phone at
(408) 981-4640.
Dr Preethi Kuknooru is licensed to practice in Illinois (license number 019030943) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1174079305.
Healthcare Provider's Profile
| Full Name | Dr Preethi Kuknooru |
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| Gender | Female |
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| Speciality | Dentist |
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| Location | 4450 Lockhill Selma Rd Ste 101, Shavano Park, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1174079305
- Provider Enumeration Date: 08/28/2016
- Last Update Date: 03/28/2022
Medicare PECOS Information:
- PECOS PAC ID: 8527314855
- Enrollment ID: I20180628002924
Medical Identifiers
Medical identifiers for Dr Preethi Kuknooru such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1174079305 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 122300000X | Dentist | 368-83 (Texas) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 122300000X | Dentist | 019030943 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Preethi Kuknooru is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Preethi Kuknooru, DDS
4450 Lockhill Selma Rd Ste 101,
Shavano Park, TX 78249-4394
Ph: (408) 981-4640 | Dr Preethi Kuknooru, DDS
4450 Lockhill Selma Rd Ste 101,
Shavano Park, TX 78249-4394
Ph: (408) 981-4640 |
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