Individual provider Active NPI

Vanila Godara, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Irvine, CA
National Provider Identifier
1548600844
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DDS103737 Issued in CA
Practice address
2500 Alton Pkwy
Ste 202 & 208
Irvine, CA 92606-5034
Phone
(714) 557-7744
NPI assigned
Jul 1, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS103737 CA
Dentist 122300000X DE60390138 WA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DDS103737 CA Primary

Addresses

Primary practice location

2500 Alton Pkwy
Ste 202 & 208
Irvine, CA 92606-5034

Mailing address

2500 Alton Pkwy Ste 202&208
Irvine, CA 92606-5024
Phone (714) 557-7744

Other practice location 1

10404 Silverdale Way NW
#109e
Silverdale, WA 98383-9461
Phone (360) 536-9033

Other practice location 2

5685 Alton Pkwy
Irvine, CA 92618
Phone (949) 236-6527

Other practice location 3

10404 Silverdale Way NW
#109e
Silverdale, WA 98383-9461
Phone (360) 536-9033

Other names 1

  • Vanila Choudhry Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250217002795 CA Practitioner - Oral Surgery 9032639349 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS103737CAMDDentist
DE60390138WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Vanila Choudhry DDS Inc CurrentSince Apr 3, 2020 Accepting new patients
Scott and Kansagra Dental PastSince Sep 1, 2019 Accepting new patients
Nurani, Mitchell, Kim, PC Dentist Past Accepting new patients

Locations

2500 Alton Pkwy
Ste 202208
Irvine, CA 92606
Phone (714) 557-7744

2500 Alton Pkwy
Ste 202
Irvine, CA 92606
Phone (714) 557-7744

Organizations & group practices 3

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": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1548600844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 ALTON PKWY STE 202&208",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926065024",
            "telephone_number": "714-557-7744",
            "fax_number": "714-540-5718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ALTON PKWY",
            "address_2": "STE 202 & 208",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926065034",
            "telephone_number": "714-557-7744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10404 Silverdale Way NW",
            "address_2": "#109e",
            "address_purpose": "LOCATION",
            "city": "Silverdale",
            "state": "WA",
            "postal_code": "983839461",
            "country_code": "US",
            "telephone_number": "360-536-9033",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5685 Alton Pkwy",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "92618",
            "country_code": "US",
            "telephone_number": "949-236-6527",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10404 Silverdale Way NW",
            "address_2": "#109e",
            "address_purpose": "LOCATION",
            "city": "Silverdale",
            "state": "WA",
            "postal_code": "983839461",
            "country_code": "US",
            "telephone_number": "360-536-9033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GODARA",
        "first_name": "VANILA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-01",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS103737",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60390138",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "DDS103737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VANILA",
            "last_name": "CHOUDHRY",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.