Jaya Vallabhaneni, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 012273 Issued in GA

Practice address

3273 Shallowford Rd NE
Atlanta, GA 30341-3632

Phone

(770) 455-0628

Fax

(770) 451-7521

NPI assigned

Oct 26, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Av Dental Care, PC

  • General Practice Dentistry
  • Atlanta, GA
  • NPI 1922139567
  NPD (past) Authorized official

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300665600000",
    "number": "1407846793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 SAINT REGIS LN",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300221653",
            "telephone_number": "770-993-1284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3273 SHALLOWFORD RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303413632",
            "telephone_number": "770-455-0628",
            "fax_number": "770-451-7521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLABHANENI",
        "first_name": "JAYA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2011-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN 012273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "853472301B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Leigh Valentino, PSY.D.
• Vanessa Valentino
• Valerie S Marler,PH.D.,P.C.
• Valet Guardian LLC
• Kiran Valiani
• Javier Valle, M.D., MPH
• Tai E Valliere-White, MD
• Annmarie Vallomthail
• Joseph M Vallor, PA
• Jessica Valor, MASSAGE THERAPIST

• General Practice Dentistry in Atlanta, GA
• Providers in Atlanta, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.