Individual provider Active NPI

Divya Iyer, DMD

  • Pediatric Dentistry
  • Wichita Falls, TX
National Provider Identifier
1700011160
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
26380 Issued in TX
Practice address
1 Eureka Cir
Suite 103
Wichita Falls, TX 76308-2929
Phone
(940) 691-5027
NPI assigned
May 28, 2009
Last updated
Sep 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 26380 TX Primary

Addresses

Primary practice location

1 Eureka Cir
Suite 103
Wichita Falls, TX 76308-2929

Mailing address

1 Eureka Cir
Suite 103
Wichita Falls, TX 76308-2929
Phone (940) 691-5027

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
26380TXMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
United Regional Health Care System Inc Current Accepting new patients
Divya Venkataraman DMD PLLC Pediatric Dentistry Current Accepting new patients

Locations

1 Eureka Cir
Ste 103
Wichita Falls, TX 76308
Phone (469) 522-3306

Interoperability endpoints

  • Direct secure messaging: diyer14012@unitedregional.medalliesdirect.net
  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1700011160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EUREKA CIR",
            "address_2": "SUITE 103",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763082929",
            "telephone_number": "940-691-5027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EUREKA CIR",
            "address_2": "SUITE 103",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763082929",
            "telephone_number": "940-691-5027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IYER",
        "first_name": "DIVYA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-28",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "26380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.