Individual provider Active NPI

Vaishnavi Chepyala

  • General Practice Dentistry
  • Mesa, AZ
National Provider Identifier
1407585342
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D011176 Issued in AZ
Practice address
10664 E Point Twenty Two Blvd
Mesa, AZ 85212-8874
Phone
(480) 360-3073
NPI assigned
Jun 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D011176 AZ Primary

Addresses

Primary practice location

10664 E Point Twenty Two Blvd
Mesa, AZ 85212-8874

Mailing address

10664 E Point Twenty Two Blvd
Mesa, AZ 85212-8874
Phone (480) 360-3073

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

LicenseStateTypeSpecialty
D011176AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Signal Butte Kids Dentistry and Orthodontics, LLP CurrentSince Jun 12, 2022 Accepting new patients

Locations

10664 E Point Twenty Two Blvd
Mesa, AZ 85212
Phone (480) 360-3073

Organizations & group practices 1

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": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1407585342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10664 E POINT TWENTY TWO BLVD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852128874",
            "telephone_number": "480-360-3073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10664 E POINT TWENTY TWO BLVD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852128874",
            "telephone_number": "480-360-3073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEPYALA",
        "first_name": "VAISHNAVI",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D011176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.

Verify at the official NPI Registry.