Individual provider Active NPI

Priyadarshini Beedu, D.D.S.

  • General Practice Dentistry
  • Milpitas, CA
National Provider Identifier
1639135478
Registry record updated Apr 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
59977 Issued in CA
Practice address
1119 S Park Victoria Dr
Milpitas, CA 95035-6942
Phone
(408) 945-4333
Fax
(408) 945-4336
NPI assigned
Apr 21, 2006
Last updated
Apr 6, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8087 NC
General Practice Dentistry 1223G0001X 59977 CA Primary

Addresses

Primary practice location

1119 S Park Victoria Dr
Milpitas, CA 95035-6942

Mailing address

1119 S Park Victoria Dr
Milpitas, CA 95035-6942
Phone (408) 945-4333

Other identifiers 2

IdentifierTypeStateIssuer
1639135478MedicaidNC
899025GMedicaidNC

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
59977CAMDGeneral Practice Dentistry
8087NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Priyabeedu DDS Inc CurrentSince Jan 12, 2025 Accepting new patients

Locations

1119 S Park Victoria Dr
Milpitas, CA 95035
Phone (408) 945-4333

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522972800000",
    "number": "1639135478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 S PARK VICTORIA DR",
            "city": "MILPITAS",
            "state": "CA",
            "postal_code": "950356942",
            "telephone_number": "408-945-4333",
            "fax_number": "408-945-4336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 S PARK VICTORIA DR",
            "city": "MILPITAS",
            "state": "CA",
            "postal_code": "950356942",
            "telephone_number": "408-945-4333",
            "fax_number": "408-945-4336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEEDU",
        "first_name": "PRIYADARSHINI",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2018-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "8087",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639135478",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "899025G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milpitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.