Active NPI
Deepika Naidu Thota
- Prosthodontics
- Reston, VA
National Provider Identifier
1093599284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 0401418596
- Practice address
- 1939 Roland Clarke PL Ste 120
Reston, VA 20191-1445 - Phone
- (571) 616-9685
- NPI assigned
- Aug 21, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 0401418596 | VA | Primary |
Addresses
Primary practice location
1939 Roland Clarke PL Ste 120
Reston, VA 20191-1445
Mailing address
1939 Roland Clarke PL Ste 120
Reston, VA 20191-1445
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401418596 | VA | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692576000000",
"number": "1093599284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1939 ROLAND CLARKE PL STE 120",
"city": "RESTON",
"state": "VA",
"postal_code": "201911445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1939 ROLAND CLARKE PL STE 120",
"city": "RESTON",
"state": "VA",
"postal_code": "201911445",
"telephone_number": "571-616-9685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOTA",
"first_name": "DEEPIKA NAIDU",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-21",
"last_updated": "2023-08-21",
"certification_date": "2023-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "VA",
"license": "0401418596",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reston, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.