Individual provider Active NPI

Lavanya Venkateswaran, DDS

  • Pediatric Dentistry
  • New York, NY
National Provider Identifier
1588812572
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
055973-1 Issued in NY
Practice address
44 Lispenard St
Suite a
New York, NY 10013-2550
Phone
(212) 473-4444
NPI assigned
Sep 3, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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 055973-1 NY Primary

Addresses

Primary practice location

44 Lispenard St
Suite a
New York, NY 10013-2550

Mailing address

22 Ave at Port Imperial
Apt 524
West New York, NJ 07093-7800

Other identifiers 1

IdentifierTypeStateIssuer
055973-1OtherNYNY STATE DENTAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20160616001229 NY Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 7113218413

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
055973-1NYMDPediatric Dentist
055973NYMDPharmacist

Interoperability endpoints

  • Direct secure messaging: lvenkateswaran1672096@nychhc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1588812572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 AVE AT PORT IMPERIAL",
            "address_2": "APT 524",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070937800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 LISPENARD ST",
            "address_2": "SUITE A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100132550",
            "telephone_number": "212-473-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENKATESWARAN",
        "first_name": "LAVANYA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "055973-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE  DENTAL LICENSE",
            "identifier": "055973-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.