Individual provider Active NPI

Vasudha Narra, DDS

  • General Practice Dentistry
  • Mesa, AZ
National Provider Identifier
1619120540
Registry record updated Oct 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7658 Issued in AZ
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, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160428001075 AZ Order and Referring Only - DentistPractitioner - Dentist 6305074659

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brivadental LLC PastSince Oct 1, 2012 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

Verify at the official NPI Registry.