Individual provider Active NPI

Deepthi Maya

  • Dentist
  • Camdenton, MO
National Provider Identifier
1083323406
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2024000916 Issued in MO
Practice address
1652 N Business RT 5
Camdenton, MO 65020
Phone
(877) 406-2662
NPI assigned
Nov 15, 2022
Last updated
Jun 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 016.0134149 VT
Dentist 122300000X 2024000916 MO Primary

Addresses

Primary practice location

1652 N Business RT 5
Camdenton, MO 65020

Mailing address

126 Raef Rd
Lebanon, MO 65536-4486
Phone (765) 492-9042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20250703000223 MO Practitioner - Dentist 1658884465 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016.0134149VTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Richland Medical Center, Inc. Current Accepting new patients
Aman U Syed PLC Dentist PastSince Nov 1, 2022 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1083323406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 RAEF RD",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655364486",
            "telephone_number": "765-492-9042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1652 N BUSINESS RT 5",
            "city": "CAMDENTON",
            "state": "MO",
            "postal_code": "65020",
            "telephone_number": "877-406-2662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYA",
        "first_name": "DEEPTHI",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-15",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VT",
            "license": "016.0134149",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2024000916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camdenton, MO

Sources for this page

Verify at the official NPI Registry.