Vijaya Sen Reddy Gaddam

Primary specialty

DentistTaxonomy code 122300000X

License

059473 Issued in NY

Practice address

1873 Western Ave
Suite 200
Albany, NY 12203-5028

Phone

(518) 869-1044

NPI assigned

Apr 8, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Emblemhealth Medical and Dental Services Inc.

  • Health Service Clinic/Center
  • Albany, NY
  • NPI 1275823734
  NPD (past)
• Group Health Incorporated

  • Dental Clinic/Center
  • Albany, NY
  • NPI 1629175831
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1043674633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 DEY ST",
            "address_2": "APT. 174",
            "city": "HARRISON",
            "state": "NJ",
            "postal_code": "070291787",
            "telephone_number": "940-395-6265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1873 WESTERN AVE",
            "address_2": "SUITE 200",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122035028",
            "telephone_number": "518-869-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADDAM",
        "first_name": "VIJAYA SEN",
        "middle_name": "REDDY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "059473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Gabriels
• Firmin (F) Forrest Gabriels, MD
• Gabrielseyemds
• Sergo Gabunia, MD
• Jamie Marie Gachowski, M ED OTR L
• Therese M Gadomski, RD,CDE,CDN
• Annmarie Ceriello Gaetani, N.P.
• Lindsay Elizabeth Gaetani, NP
• Gaetano Gialanella PLLC
• Barry Gaffney, L.PN

• Dentist in Albany, NY
• Providers in Albany, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.