Active NPI
Vasudha Narra, DDS
- General Practice Dentistry
- Mesa, AZ
National Provider Identifier
1619120540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7658
- Practice address
- 67 N Dobson Rd Ste 104
Mesa, AZ 85201-6824 - Phone
- (888) 785-2336
- NPI assigned
- Oct 22, 2008
- Last updated
- Oct 22, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7658 | AZ | Primary |
Addresses
Primary practice location
67 N Dobson Rd Ste 104
Mesa, AZ 85201-6824
Mailing address
14860 N 88TH LN
Peoria, AZ 85381-2782
Phone (623) 242-0143
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160428001075 | AZ | Order and Referring Only - Dentist | 6305074659 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brivadental LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224633600000",
"number": "1619120540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14860 N 88TH LN",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853812782",
"telephone_number": "623-242-0143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "67 N DOBSON RD STE 104",
"city": "MESA",
"state": "AZ",
"postal_code": "852016824",
"telephone_number": "888-785-2336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NARRA",
"first_name": "VASUDHA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-22",
"last_updated": "2008-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "7658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; 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.