Individual provider Active NPI

Goda Devi Subha Hajeebu Venkata, DMD

  • Dentist
  • Coral Springs, FL
National Provider Identifier
1629322359
Registry record updated Nov 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN19920 Issued in FL
Practice address
11606 Nw48Th Street
Coral Springs, FL 33076
Phone
(954) 415-2098
NPI assigned
Nov 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN19920 FL Primary

Addresses

Primary practice location

11606 Nw48Th Street
Coral Springs, FL 33076

Mailing address

11606 NW 48TH St
Coral Springs, FL 33076-3525
Phone (954) 415-2098

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN19920FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1351814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351814400000",
    "number": "1629322359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11606 NW 48TH ST",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330763525",
            "telephone_number": "954-415-2098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11606 NW48TH STREET",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "33076",
            "telephone_number": "954-415-2098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAJEEBU VENKATA",
        "first_name": "GODA DEVI SUBHA",
        "name_prefix": "Mrs.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-02",
        "last_updated": "2012-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.