Vamsi Kallepalli, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN16757 Issued in FL

Practice address

3261 S US Highway 27 # 441E-1
Fruitland Park, FL 34731-4497

Phone

(352) 314-2729

Fax

(352) 314-9889

NPI assigned

Mar 8, 2006

Sex

Male

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 FL

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

Locations

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.

• Lake Village Dental

  • Public Health Dentistry
  • Fruitland Park, FL
  • NPI 1760073217
  NPD Authorized official

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1225005259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3261 S US HIGHWAY 27 # 441E-1",
            "city": "FRUITLAND PARK",
            "state": "FL",
            "postal_code": "347314497",
            "telephone_number": "352-314-2729",
            "fax_number": "352-314-9889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3261 S US HIGHWAY 27 # 441E-1",
            "city": "FRUITLAND PARK",
            "state": "FL",
            "postal_code": "347314497",
            "telephone_number": "352-314-2729",
            "fax_number": "352-314-9889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLEPALLI",
        "first_name": "VAMSI",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN16757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Lamar Johnson, NURSE
• Chase Johnson
• Melissa Jonaitis
• Trenitie Jonaitis
• Romina Jones
• KC Transit LLC
• Lake Village Dental
• Michelle S. Leclear-Dozier, LCSW
• Cynthia Loben
• Lubis Enterprise LLC

• Dentist in Fruitland Park, FL
• Providers in Fruitland Park, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; 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.