Active NPI
Vikram Mishra, D.D.S
- Dentist
- Chatsworth, CA
National Provider Identifier
1306934328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DDS49602
- Practice address
- 21800 Devonshire St
Chatsworth, CA 91311 - Phone
- (818) 709-1200
- Fax
- (818) 709-1239
- NPI assigned
- Oct 11, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | DDS49602 | CA | Primary |
Addresses
Primary practice location
21800 Devonshire St
Chatsworth, CA 91311
Mailing address
21800 Devonshire St
Chatsworth, CA 91311
Phone (818) 709-1200
Other practice location 1
1960 Sequoia Ave Ste 1
Simi Valley, CA 93063-3176
Phone (805) 584-3999
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS49602 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mishra Dental Corporation | General Practice | Past | Accepting new patients |
| Jeffrey Proniloff, DDS, Inc | General Practice | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Sequoia Dentistry
- General Practice Dentistry
- Simi Valley, CA
- NPI 1891441317
-
dba Sequoia Dentistry
- General Practice Dentistry
- Simi Valley, CA
- NPI 1558081430
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645574400000",
"number": "1306934328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21800 DEVONSHIRE ST",
"city": "CHATSWORTH",
"state": "CA",
"postal_code": "91311",
"telephone_number": "818-709-1200",
"fax_number": "818-709-1239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21800 DEVONSHIRE ST",
"city": "CHATSWORTH",
"state": "CA",
"postal_code": "91311",
"telephone_number": "818-709-1200",
"fax_number": "818-709-1239"
}
],
"practiceLocations": [
{
"address_1": "1960 Sequoia Ave Ste 1",
"address_purpose": "LOCATION",
"city": "Simi Valley",
"state": "CA",
"postal_code": "930633176",
"country_code": "US",
"telephone_number": "805-584-3999",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MISHRA",
"first_name": "VIKRAM",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-11",
"last_updated": "2022-02-23",
"certification_date": "2022-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "DDS49602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chatsworth, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.