Individual provider Active NPI

Pavani Gedela, DDS

  • General Practice Dentistry
  • Sterling, VA
National Provider Identifier
1669827671
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401415868 Issued in VA
Practice address
46400 Benedict Dr Ste 109
Sterling, VA 20164-6605
Phone
(703) 444-3412
Fax
(703) 444-3409
NPI assigned
Apr 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401415868 VA
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 0401415868 VA Primary

Addresses

Primary practice location

46400 Benedict Dr Ste 109
Sterling, VA 20164-6605

Mailing address

46400 Benedict Dr Ste 109
Sterling, VA 20164-6605
Phone (703) 444-3412

Other practice location 1

3119 Valley Ave Ste 108
Winchester, VA 22601-2665
Phone (540) 535-2099

Other practice location 2

1005 Dr Db Todd Jr Blvd
Meharry Medical College
Nashville, TN 37208-3501
Phone (615) 963-3152

Other practice location 3

3561 Ramsay St Apt 1C
High Point, NC 27265-9023
Phone (415) 889-3003

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
0401415868VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
PVS Dental PLLC General Practice CurrentSince Jan 19, 2025 Accepting new patients
Brighter Smile Family Dentistry and Orthodontics General Practice CurrentSince Jan 19, 2025 Accepting new patients

Locations

46400 Benedict Dr
Ste 109
Sterling, VA 20164
Phone (703) 444-3412

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": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1669827671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46400 BENEDICT DR STE 109",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201646605",
            "telephone_number": "703-444-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46400 BENEDICT DR STE 109",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201646605",
            "telephone_number": "703-444-3412",
            "fax_number": "703-444-3409"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3119 Valley Ave Ste 108",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226012665",
            "country_code": "US",
            "telephone_number": "540-535-2099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1005 Dr Db Todd Jr Blvd",
            "address_2": "Meharry Medical College",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372083501",
            "country_code": "US",
            "telephone_number": "615-963-3152",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3561 Ramsay St Apt 1C",
            "address_purpose": "LOCATION",
            "city": "High Point",
            "state": "NC",
            "postal_code": "272659023",
            "country_code": "US",
            "telephone_number": "415-889-3003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEDELA",
        "first_name": "PAVANI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-27",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401415868",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401415868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.