Active NPI
Pariksha Gunnala, DDS
- Dentist
- Camarillo, CA
National Provider Identifier
1124337126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 102333
- Practice address
- 4900 Verdugo Way
Suite a
Camarillo, CA 93012 - Phone
- (805) 484-7277
- NPI assigned
- Sep 25, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 25738 | TX | |
| Dentist | 122300000X | 102333 | CA | Primary |
Addresses
Primary practice location
4900 Verdugo Way
Suite a
Camarillo, CA 93012
Mailing address
1651 Falling Star Ave
Westlake Village, CA 91362-5282
Phone (602) 405-6195
Other practice location 1
2246 Jacksboro Hwy Ste 112
Fort Worth, TX 76114-2363
Phone (817) 529-1799
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124337126 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181017003798 | CA | Order and Referring Only - Dentist | 8729330881 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102333 | CA | MD | Dentist |
| 25738 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bob Jing DDS PA | General Practice | Past | Accepting new patients |
| Workings and Lambridis Dental Corporation | General Practice | Past | 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Camarillo, CA
- NPI 1922198316
-
- General Practice Dentistry
- Fort Worth, TX
- NPI 1437304771
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533168000000",
"number": "1124337126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1651 FALLING STAR AVE",
"city": "WESTLAKE VILLAGE",
"state": "CA",
"postal_code": "913625282",
"telephone_number": "602-405-6195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4900 VERDUGO WAY",
"address_2": "SUITE A",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "93012",
"telephone_number": "805-484-7277"
}
],
"practiceLocations": [
{
"address_1": "2246 Jacksboro Hwy Ste 112",
"address_purpose": "LOCATION",
"city": "Fort Worth",
"state": "TX",
"postal_code": "761142363",
"country_code": "US",
"telephone_number": "817-529-1799",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GUNNALA",
"first_name": "PARIKSHA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-25",
"last_updated": "2018-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "25738",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "102333",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1124337126",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Camarillo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; 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.