Vamsi Krishna Kalavacharla, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10896 Issued in NC

Practice address

4251 Ramsey St Ste 8
Fayetteville, NC 28311-2130

Phone

(910) 716-0105

NPI assigned

Oct 27, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1509062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1407368707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4251 RAMSEY ST STE 8",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283112130",
            "telephone_number": "910-716-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4251 RAMSEY ST STE 8",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283112130",
            "telephone_number": "910-716-0105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7181 N Hualapai Way Ste 105",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891661116",
            "country_code": "US",
            "telephone_number": "702-852-2244",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7181 N Hualapai Way Ste 105",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891661116",
            "country_code": "US",
            "telephone_number": "702-852-2244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALAVACHARLA",
        "first_name": "VAMSI",
        "middle_name": "KRISHNA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "6976",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "10896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.

Verify at the official NPI Registry.