Individual provider Active NPI

Divya R Sankepally, DDS

  • General Practice Dentistry
  • Vienna, VA
National Provider Identifier
1497033302
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401413165 Issued in VA
Practice address
410 Pine St SE Ste 100
Vienna, VA 22180-4861
Phone
(703) 938-1415
Fax
(703) 255-0295
NPI assigned
Jul 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

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 0401413165 VA Primary

Addresses

Primary practice location

410 Pine St SE Ste 100
Vienna, VA 22180-4861

Mailing address

410 Pine St SE Ste 100
Vienna, VA 22180-4861
Phone (703) 938-1415

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
0401413165VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1311638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1497033302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 PINE ST SE STE 100",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804861",
            "telephone_number": "703-938-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 PINE ST SE STE 100",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804861",
            "telephone_number": "703-938-1415",
            "fax_number": "703-255-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANKEPALLY",
        "first_name": "DIVYA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-26",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401413165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; 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.