Individual
PRASHANT CHARUGUNDLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3332 N LOMBARD ST STE C, PORTLAND, OR 97217-1258
(503) 548-2006
(503) 548-2012
Mailing address
3332 N LOMBARD ST STE C, PORTLAND, OR 97217-1258
(503) 548-2006
(503) 548-2012
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
0401418116
VA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
0438000474
VA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D11891
OR
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
D11891
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2017
Last updated
04/06/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us