Individual provider Active NPI

Asita Jenani Vinayagalingam, DMD

  • General Practice Dentistry
  • Springboro, OH
National Provider Identifier
1184248692
Registry record updated Feb 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.026663 Issued in OH
Practice address
18 Remick Blvd
Springboro, OH 45066-9168
Phone
(937) 350-5379
NPI assigned
May 31, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 30.026663 OH Primary

Addresses

Primary practice location

18 Remick Blvd
Springboro, OH 45066-9168

Mailing address

3721 Shiraz CT
Bellbrook, OH 45305-7505

Other practice location 1

4380 Buckeye Ln Ste 218
Beavercreek, OH 45440-7310
Phone (937) 912-0101

Other practice location 2

5395 Burkhardt Rd
Dayton, OH 45431-2109
Phone (937) 253-3601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20200803002049 MI Order and Referring Only - DentistPractitioner - Dentist 3173948528

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.026663OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Cory B Sellers DDS LLC General Practice PastSince Nov 6, 2022 Accepting new patients
Cory B. Sellers, DDS, LLC, Springboro General Practice PastSince Nov 1, 2022 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.

NPI Registry JSON

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

{
    "created_epoch": "1590883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644710400000",
    "number": "1184248692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 SHIRAZ CT",
            "city": "BELLBROOK",
            "state": "OH",
            "postal_code": "453057505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 REMICK BLVD",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450669168",
            "telephone_number": "937-350-5379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4380 Buckeye Ln Ste 218",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454407310",
            "country_code": "US",
            "telephone_number": "937-912-0101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5395 Burkhardt Rd",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454312109",
            "country_code": "US",
            "telephone_number": "937-253-3601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VINAYAGALINGAM",
        "first_name": "ASITA",
        "middle_name": "JENANI",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-31",
        "last_updated": "2022-02-13",
        "certification_date": "2022-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.026663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springboro, OH

Sources for this page

Verify at the official NPI Registry.