Madhavi -------------------- Neerumalla, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

50497 Issued in CA

Practice address

2440 N.Texas St
Fairfield, CA 94533

Phone

(707) 422-4696

Fax

(707) 422-0396

NPI assigned

Jan 31, 2007

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 CA

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

Interoperability endpoints

• Direct secure messaging: mneerumalla@direct.westerndental.com

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.

• Western Dental Services, Inc.

  • General Practice Dentistry
  • Fairfield, CA
  • NPI 1912050147
  NPD (past)

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154468098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 PYRAMID CT",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "94534",
            "telephone_number": "707-864-8871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 N.TEXAS ST",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "94533",
            "telephone_number": "707-422-4696",
            "fax_number": "707-422-0396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEERUMALLA",
        "first_name": "MADHAVI",
        "middle_name": "--------------------",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "50497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amara B Neals
• Arica Janel Nears Taylor
• Desirae Danielle Comstock Nears
• Lemel Nears
• Melba-Jean Nears
• Mikayla Renee Negron-Foster
• Grace Nelson
• Kima Kristi Nelson
• Sharayah Brooke Nelson, CATC
• Tyler Elliott Nelson, D.M.D.

• Dentist in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.