Active NPI
Vineela Redla, BDS
- Pediatric Dentistry
- Middletown, OH
National Provider Identifier
1699043422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 30.026037
- Practice address
- 210 S Breiel Blvd Ste 2
Middletown, OH 45044-5152 - Phone
- (513) 423-9239
- Fax
- (513) 423-4188
- NPI assigned
- Dec 7, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 058723-1 | NY | |
| Pediatric Dentistry | 1223P0221X | 30.026037 | OH | Primary |
Addresses
Primary practice location
210 S Breiel Blvd Ste 2
Middletown, OH 45044-5152
Mailing address
210 S Breiel Blvd Ste 2
Middletown, OH 45044-5152
Phone (513) 423-9239
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 058723-1 | NY | MD | General Practice Dentistry |
| 30.026037 | OH | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Dental Associates PLLC | General Practice | Past | 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.
-
- Pediatric Dentistry
- Williamsville, NY
- NPI 1144730649
General Practice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702857600000",
"number": "1699043422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 S BREIEL BLVD STE 2",
"city": "MIDDLETOWN",
"state": "OH",
"postal_code": "450445152",
"telephone_number": "513-423-9239",
"fax_number": "513-423-4188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 S BREIEL BLVD STE 2",
"city": "MIDDLETOWN",
"state": "OH",
"postal_code": "450445152",
"telephone_number": "513-423-9239",
"fax_number": "513-423-4188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDLA",
"first_name": "VINEELA",
"name_prefix": "Dr.",
"credential": "BDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-07",
"last_updated": "2023-12-18",
"certification_date": "2023-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "058723-1",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "OH",
"license": "30.026037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.