Active NPI
Purvi Vadaliya, DDS
- General Practice Dentistry
- Jacksonville, FL
National Provider Identifier
1215501762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 26346
- Practice address
- 3068 Brettungar Dr
Jacksonville, FL 32246-5503 - Phone
- (678) 670-1216
- NPI assigned
- May 19, 2021
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | 26346 | FL | Primary |
Addresses
Primary practice location
3068 Brettungar Dr
Jacksonville, FL 32246-5503
Mailing address
3068 Brettungar Dr
Jacksonville, FL 32246-5503
Phone (678) 670-1216
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26346 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643932800000",
"number": "1215501762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3068 BRETTUNGAR DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322465503",
"telephone_number": "678-670-1216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3068 BRETTUNGAR DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322465503",
"telephone_number": "678-670-1216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VADALIYA",
"first_name": "PURVI",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-19",
"last_updated": "2022-02-04",
"certification_date": "2022-02-04",
"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": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "26346",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.