Vasudha Banuru, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D13463 Issued in MN

Practice address

Dental Associates of Savage
13899 Highway 13 South Frontage Rd.
Savage, MN 55378

Phone

(952) 440-2292

Fax

(952) 440-2935

NPI assigned

Jul 20, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

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.

• Banuru Shetty Dental Group, P.L.L.C

  • General Practice Dentistry
  • Eden Prairie, MN
  • NPI 1295566628
  NPD Authorized official

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

{
    "created_epoch": "1405814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1588071781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15750 ROCKFORD RD",
            "address_2": "APT # 224",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554464203",
            "telephone_number": "201-336-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DENTAL ASSOCIATES OF SAVAGE",
            "address_2": "13899 HIGHWAY 13 SOUTH FRONTAGE RD.",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "55378",
            "telephone_number": "952-440-2292",
            "fax_number": "952-440-2935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANURU",
        "first_name": "VASUDHA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-20",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Associated Partnership LTD
• Autism Fitness & Fun Center
• Faduma A Awgeydhe
• Susan J. Baker, PSY.D.
• Brittany Baldry, PHARMD
• Baraka Family Care LLC
• Kenneth Randall Barnett, D.C.
• Barton Davis DDS PLLC
• Rae Ann Beaver, DC
• Britin Becker, LPCC

• All providers in Savage, MN
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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.