Active NPI
Sailaja Kuruvadi, DDS
- General Practice Dentistry
- Chula Vista, CA
National Provider Identifier
1407137730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 39431
- Practice address
- 730 Broadway Ste 104
Chula Vista, CA 91910-5362 - Phone
- (619) 405-7572
- NPI assigned
- Aug 31, 2011
- Last updated
- Nov 13, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 39431 | CA | Primary |
Addresses
Primary practice location
730 Broadway Ste 104
Chula Vista, CA 91910-5362
Mailing address
1111 Majestad LN
Chula Vista, CA 91910-7924
Phone (619) 405-7572
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 |
|---|---|---|---|
| 39431 | CA | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542067200000",
"number": "1407137730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 MAJESTAD LN",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919107924",
"telephone_number": "619-405-7572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "730 BROADWAY STE 104",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919105362",
"telephone_number": "619-405-7572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KURUVADI",
"first_name": "SAILAJA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-31",
"last_updated": "2018-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "39431",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chula Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.