Individual provider Active NPI

Vaishnavi Gummadi

  • General Practice Dentistry
  • Arlington, TX
National Provider Identifier
1487147781
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
34150 Issued in TX
Practice address
4898 Little Rd
Arlington, TX 76017-1054
Phone
(817) 672-0034
NPI assigned
Jun 11, 2018
Last updated
Jun 11, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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 34150 TX Primary

Addresses

Primary practice location

4898 Little Rd
Arlington, TX 76017-1054

Mailing address

1103 W 30TH St Apt 3
Los Angeles, CA 90007-5336
Phone (804) 551-0572

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
34150TXMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1487147781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 W 30TH ST APT 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900075336",
            "telephone_number": "804-551-0572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4898 LITTLE RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760171054",
            "telephone_number": "817-672-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMMADI",
        "first_name": "VAISHNAVI",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.