Vidyavathi Konegowda, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

28602 Issued in TX

Practice address

3030 LBJ Fwy
Suite 1400
Dallas, TX 75234-7781

Phone

(972) 444-8888

NPI assigned

Jul 2, 2012

Last updated

Feb 26, 2015By the provider in NPPES

Sex

Female

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

Enrolled in TX

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kleen Dental PLLC

  dba Harbor Point Dental Excellence

  • Dental Clinic/Center
  • Garland, TX
  • NPI 1851891964
  NPD (past) Authorized official

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424908800000",
    "number": "1245594589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1076 ARCHES PARK DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750135649",
            "telephone_number": "248-613-5147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 LBJ FWY",
            "address_2": "SUITE 1400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752347781",
            "telephone_number": "972-444-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONEGOWDA",
        "first_name": "VIDYAVATHI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-02",
        "last_updated": "2015-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020698",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "28602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mamatha Kondapalli, M.D.
• Nitin Kondapalli, MBBS
• Sainath Kondapaneni
• Ragini Kondetimmanahalli, MD
• Kartik Konduri, MD
• Konektz LLC (1st Choice)
• Konektz LLC (1st Heritage Way)
• Konektz LLC (1st Heritage Way)
• Konen & Associates, PA (Unified Pain Management)
• Andrew A. Konen, M.D.

• General Practice Dentistry in Dallas, TX
• Providers in Dallas, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; 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.