Individual provider Active NPI

Sirisha Vasireddy, DMD

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1659005379
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D011503 Issued in AZ
Practice address
2525 W Carefree Hwy Ste 154
Phoenix, AZ 85085-9305
Phone
(623) 533-5699
NPI assigned
Jul 11, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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 D011503 AZ Primary

Addresses

Primary practice location

2525 W Carefree Hwy Ste 154
Phoenix, AZ 85085-9305

Mailing address

2342 Carrington St NW
North Canton, OH 44720-8182
Phone (330) 280-4912

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
D011503AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Carefree Smiles PLLC General Practice PastSince Jul 17, 2022 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1659005379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2342 CARRINGTON ST NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447208182",
            "telephone_number": "330-280-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 W CAREFREE HWY STE 154",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850859305",
            "telephone_number": "623-533-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASIREDDY",
        "first_name": "SIRISHA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-11",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D011503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; 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.