Individual provider Active NPI

Bindu M Vemaraju, DDS

  • Dentist
  • Chantilly, VA
National Provider Identifier
1629417654
Registry record updated Mar 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401414094 Issued in VA
Practice address
25401 Eastern Marketplace PLZ
Suite 165
Chantilly, VA 20152-5782
Phone
(703) 542-3171
Fax
(703) 542-7325
NPI assigned
Jun 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 16310 MD
Dentist 122300000X 0401414094 VA Primary

Addresses

Primary practice location

25401 Eastern Marketplace PLZ
Suite 165
Chantilly, VA 20152-5782

Mailing address

722 E Pulaski Hwy Ste 102
Elkton, MD 21921-6029
Phone (410) 202-0198

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
16310MDMDClinical Social Worker
0401414094VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Neibauer Dental Care, PC General Practice Past Accepting new patients
Neibauer Dental Care Dentist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1629417654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 E PULASKI HWY STE 102",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219216029",
            "telephone_number": "410-202-0198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25401 EASTERN MARKETPLACE PLZ",
            "address_2": "SUITE 165",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201525782",
            "telephone_number": "703-542-3171",
            "fax_number": "703-542-7325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEMARAJU",
        "first_name": "BINDU",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-24",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "16310",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401414094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; 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.