Individual provider Active NPI

Padmaja Yalamanchili, D.D.S.

  • General Practice Dentistry
  • Fairfax, VA
National Provider Identifier
1649346818
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401411072 Issued in VA
Practice address
10875 Main St Ste 103
Fairfax, VA 22030-4732
Phone
(703) 591-4010
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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 0401411072 VA Primary

Addresses

Primary practice location

10875 Main St Ste 103
Fairfax, VA 22030-4732

Mailing address

10875 Main St Ste 103
Fairfax, VA 22030-4732
Phone (703) 591-4010

Other practice location 1

5812 Mapledale Plz
Dale City, VA 22193-4535
Phone (703) 580-9900

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
0401411072VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Arnold S. Fariello, DDS PC PastSince Mar 1, 2020 Accepting new patients
Mapledale Family Dentistry, P.C. PastSince Nov 21, 2021 Accepting new patients
Dr.Padmaja Yalamanchili DDS PC General Practice PastSince Mar 1, 2020 Accepting new patients

Organizations & group practices 3

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1649346818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10875 MAIN ST STE 103",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304732",
            "telephone_number": "703-591-4010",
            "fax_number": "703-580-0358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10875 MAIN ST STE 103",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304732",
            "telephone_number": "703-591-4010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5812 Mapledale Plz",
            "address_purpose": "LOCATION",
            "city": "Dale City",
            "state": "VA",
            "postal_code": "221934535",
            "country_code": "US",
            "telephone_number": "703-580-9900",
            "fax_number": "703-580-0358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YALAMANCHILI",
        "first_name": "PADMAJA",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401411072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; 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.