Justin Villanueva, DMD, MSD, DHL

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

12013130A Issued in IN

Practice address

415 N 26TH St Ste 303
Lafayette, IN 47904-2893

Phone

(765) 447-9319

NPI assigned

Jul 25, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 10, 2020 through Jun 10, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1174076236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N 26TH ST STE 303",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042893",
            "telephone_number": "765-447-9319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N 26TH ST STE 303",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042893",
            "telephone_number": "765-447-9319"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1121 W Michigan St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025211",
            "country_code": "US",
            "telephone_number": "317-274-7433",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1650 W Oak St Ste 206",
            "address_purpose": "LOCATION",
            "city": "Zionsville",
            "state": "IN",
            "postal_code": "460773836",
            "country_code": "US",
            "telephone_number": "317-349-0419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "DMD, MSD, DHL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-25",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IN",
            "license": "12013130A",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019030729",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Via Quest Home Health of Indiana, LLC
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• Venkata Vindhyamuri
• Virata Retina Center LLC
• Steven R Virata, MD, FACS
• Joel Andrew Virkler, D.O.
• Kaitlyn Voity, MD

• Periodontics in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Periodontics in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.