Chandan Venkatesh, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02809100 Issued in NJ

Practice address

193 Westgate Dr
Edison, NJ 08820-1164

Phone

(732) 809-6688

NPI assigned

Oct 23, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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.

• Diya Dental Services LLC

  • Dental Clinic/Center
  • Edison, NJ
  • NPI 1114749934
  NPD

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

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1093314668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 WESTGATE DR",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088201164",
            "telephone_number": "732-809-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 WESTGATE DR",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088201164",
            "telephone_number": "732-809-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENKATESH",
        "first_name": "CHANDAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-23",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02809100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jillian Vassallo
• Teresa L Vega, M.D.
• Kavitha Velicheti, MD
• Vasilios Velmahos, M.D
• Stephanie C Veloso, BSN RN
• Veralake LLC
• Kristyn Tessa-Marie Verderosa, LCSW
• Madhoolika Verma, M.D.
• Purnima Verma
• Robert Anthony Vernickas, OPTICIAN

• General Practice Dentistry in Edison, NJ
• Providers in Edison, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; 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.