OrganizationActive
Mukkara Hagerstown LLC
NPI 1164094330 · Orthodontics and Dentofacial Orthopedics Dentistry · Hagerstown, MD
Provider details
- NPI number
- 1164094330
- Entity type
- Organization
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Mamata Mukkara, Orthodontist(617) 480-2348
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
322 E Antietam St Ste 103
Hagerstown, MD 21740-5736
Phone: (301) 733-1552
Fax: (301) 733-1553
Street-level locationGet directions
Mailing address
7 Kilglass Ct Apt 102
Lutherville Timonium, MD 21093-7782
Registry dates
- Enumerated
- 2021-07-15
- Last updated
- 2021-07-15
- Certified
- 2021-07-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.