Ravi Kiran Lingineni, DDS
Individual provider Active NPI General Practice Dentistry · Pearisburg, VA
NPI 1194247775 · NPPES record last updated Apr 16, 2020
Key facts
- NPI
- 1194247775
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 0401416826 (VA)
- Practice address
- 219 Buchanan St
Pearisburg, VA 24134-1901 - Phone
- (540) 921-3502
- NPI assigned
- Jul 14, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IN, VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170727003430 | IN | Order and Referring Only - Dentist |
5597035220 | |
| I20200910002950 | VA | Order and Referring Only - Dentist |
5597035220 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12012776A | IN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Familia Dental Indianapolis Avondale, LLC | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12012776A | IN | |
| General Practice Dentistry | 1223G0001X | 0401416826 | VA | Yes |
Addresses
Primary practice location
219 Buchanan St
Pearisburg, VA 24134-1901
Mailing address
219 Buchanan St
Pearisburg, VA 24134-1901
Phone (540) 921-3502
Other providers in Pearisburg, VA
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- Kimberlee R Ketchersid
- Bradley Mart Lane
- Laura Goodrich Anesthesia Services Inc
- Angela Renae Lilly
- Lupo'S Medical Transportation Company
- Jonathan M Marshall
- Katherine Elizabeth Martiniuk
- Ryan Kent Martiniuk
- Laura McCormick
All providers in Pearisburg, VA · General Practice Dentistry in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.