Vivek Doppalapudi, DDS MS DMSC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

0401008958 Issued in VA

Practice address

102 Elden St
Ste 19
Herndon, VA 20170-4868

Phone

(703) 464-0900

Fax

(703) 481-1742

NPI assigned

Aug 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Vivek Doppalapudi DDS Ms PC

  • Periodontics
  • Herndon, VA
  • NPI 1518159441
  NPD (past) Authorized official

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401148800000",
    "number": "1619083607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 ELDEN ST",
            "address_2": "STE 19",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704868",
            "telephone_number": "703-464-0900",
            "fax_number": "703-481-1742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 ELDEN ST",
            "address_2": "STE 19",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704868",
            "telephone_number": "703-464-0900",
            "fax_number": "703-481-1742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOPPALAPUDI",
        "first_name": "VIVEK",
        "name_prefix": "Dr.",
        "credential": "DDS MS DMSC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2014-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "DC",
            "license": "5855",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401008958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Herndon, VA
• Periodontics in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2014; 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.