Active NPI
Santhosh L Veeranna, DMD
- Pediatric Dentistry
- Chicopee, MA
National Provider Identifier
1265589519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DN21343
- Practice address
- 21 Bay State Rd
Chicopee, MA 01020-1521 - Phone
- (413) 437-8300
- NPI assigned
- Jan 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DN21343 | MA | Primary |
Addresses
Primary practice location
21 Bay State Rd
Chicopee, MA 01020-1521
Mailing address
21 Bay State Rd
Chicopee, MA 01020-1521
Phone (617) 818-6959
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30303580 | Medicaid | NH | |
| 0209465 | Medicaid | MA |
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 |
|---|---|---|---|
| DN21343 | MA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418169600000",
"number": "1265589519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 BAY STATE RD",
"city": "CHICOPEE",
"state": "MA",
"postal_code": "010201521",
"telephone_number": "617-818-6959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 BAY STATE RD",
"city": "CHICOPEE",
"state": "MA",
"postal_code": "010201521",
"telephone_number": "413-437-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VEERANNA",
"first_name": "SANTHOSH",
"middle_name": "L",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-05",
"last_updated": "2014-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MA",
"license": "DN21343",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30303580",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0209465",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicopee, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.