NPIMap

Organization Active NPI

Vidya Bobba, DMD, Inc.

  • General Practice Dentistry
  • San Jose, CA
National Provider Identifier
1336631936
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
47849 Issued in CA
Legal business name
VIDYA BOBBA, DMD, INC.
Practice address
6529 Crown Blvd Ste B
San Jose, CA 95120-2905
Phone
(408) 997-1251
NPI assigned
May 31, 2018
Last updated
Jul 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Vidya Bobba, DMDNPI 1316162571
Title
Ceo
Phone
(408) 997-1251

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 47849 CA Primary

Addresses

Primary practice location

6529 Crown Blvd Ste B
San Jose, CA 95120-2905

Mailing address

6529 Crown Blvd Ste B
San Jose, CA 95120-2905

National Provider Directory

National Provider Directory

Locations

6529 Crown Blvd
Ste B
San Jose, CA 95120
Phone (408) 997-1251

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626134400000",
    "number": "1336631936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6529 CROWN BLVD STE B",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951202905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6529 CROWN BLVD STE B",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951202905",
            "telephone_number": "408-997-1251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDYA BOBBA, DMD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-31",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A",
        "authorized_official_last_name": "BOBBA",
        "authorized_official_first_name": "VIDYA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "408-997-1251",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.