Individual provider Active NPI

Kumar T. Vadivel, DDS, FDS RCS, MS

  • Periodontics
  • Carrollton, TX
National Provider Identifier
1356469449
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
21292 Issued in TX
Practice address
1500 West Hebron Parkway Ste 108
Carrollton, TX 75010
Phone
(214) 731-0123
Fax
(214) 731-1122
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 21292 TX Primary

Addresses

Primary practice location

1500 West Hebron Parkway Ste 108
Carrollton, TX 75010

Mailing address

1500 West Hebron Parkway Ste 108
Carrollton, TX 75010
Phone (214) 731-0123

Other identifiers 1

IdentifierTypeStateIssuer
21292OtherTXTEXAS LICENSE NUMBER

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
21292TXMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Genyus Group PLLC CurrentSince Jan 14, 2024 Accepting new patients
Toothhq Dental Specialists Grapevine PLLC Periodontics PastSince Nov 17, 2019 Accepting new patients
Toothhq Dental Specialists Cedar Hill PLLC Periodontics PastSince Nov 17, 2019 Accepting new patients
Toothhq Dental Specialists Dallas PLLC Periodontics PastSince Nov 17, 2019 Accepting new patients
Implants & Gumcare PA Periodontics Past Accepting new patients

Locations

1500 W Hebron Pkwy
Ste 108
Carrollton, TX 75010
Phone (214) 731-0123

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1356469449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 WEST HEBRON PARKWAY STE 108",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "75010",
            "telephone_number": "214-731-0123",
            "fax_number": "214-731-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 WEST HEBRON PARKWAY STE 108",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "75010",
            "telephone_number": "214-731-0123",
            "fax_number": "214-731-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VADIVEL",
        "first_name": "KUMAR",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "DDS, FDS RCS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "21292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS LICENSE NUMBER",
            "identifier": "21292",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; 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.