Individual provider Active NPI

Varada Sahasrabudhe, DMD

  • Pediatric Dentistry
  • Minneapolis, MN
National Provider Identifier
1457233132
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
R897 Issued in MN
Practice address
701 25TH Ave S Ste 400
Minneapolis, MN 55454-1443
Phone
(612) 659-4900
NPI assigned
Jul 23, 2025
Last updated
Jul 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X R897 MN Primary

Addresses

Primary practice location

701 25TH Ave S Ste 400
Minneapolis, MN 55454-1443

Mailing address

2424 Territorial Rd Apt 529
Saint Paul, MN 55114-0029
Phone (250) 380-8595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250804000245 MN Order and Referring Only - DentistPractitioner - Dentist 4587172358

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R897MNMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1753228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1457233132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 TERRITORIAL RD APT 529",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551140029",
            "telephone_number": "250-380-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 25TH AVE S STE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541443",
            "telephone_number": "612-659-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAHASRABUDHE",
        "first_name": "VARADA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-23",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MN",
            "license": "R897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.