Individual provider Active NPI

Devika Reddy Dharmala

  • Dentist
  • Eugene, OR
National Provider Identifier
1679252407
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D11831 Issued in OR
Practice address
1055 Valley River Way
Eugene, OR 97401-2159
Phone
(541) 505-3185
NPI assigned
Jul 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D11831 OR Primary

Addresses

Primary practice location

1055 Valley River Way
Eugene, OR 97401-2159

Mailing address

1055 Valley River Way
Eugene, OR 97401-2159
Phone (541) 505-3185

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
D11831ORMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Hussain Dental LLC CurrentSince Jul 23, 2023 Accepting new patients
Garnache Dental LLC Dentist PastSince Jul 23, 2023 Accepting new patients

Locations

1055 Valley River Way
Eugene, OR 97401
Phone (541) 505-3185

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": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1679252407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 VALLEY RIVER WAY",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012159",
            "telephone_number": "541-505-3185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 VALLEY RIVER WAY",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012159",
            "telephone_number": "541-505-3185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHARMALA",
        "first_name": "DEVIKA",
        "middle_name": "REDDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-18",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D11831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.