Vasantha Rao, DMD DENTIST

Primary specialty

DentistTaxonomy code 122300000X

License

3738 Issued in SC

Practice address

6260 Hwy 76
Shobha Dental Care Center
Pendleton, SC 29670

Phone

(864) 332-0530

Fax

(864) 332-1201

NPI assigned

Dec 28, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Shobha Dental Care, PA

  • Dentist
  • Pendleton, SC
  • NPI 1346658762
  NPD (past) Authorized official

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1700942505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 DURSELY DRIVE",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "29621",
            "telephone_number": "864-222-9271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6260 HWY 76",
            "address_2": "SHOBHA DENTAL CARE CENTER",
            "city": "PENDLETON",
            "state": "SC",
            "postal_code": "29670",
            "telephone_number": "864-332-0530",
            "fax_number": "864-332-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAO",
        "first_name": "VASANTHA",
        "name_prefix": "Mrs.",
        "credential": "DMD DENTIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "3738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX3738",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pendleton Area Rescue Squad
• Pendleton Family Practice, LLC
• Pendleton Medical Clinic
• Pendleton Neighborhood Dental, LLC
• Alekhya Rao, D.M.D.
• Rathompson in (O'Boutique Luxury Optical)
• Recreate Life
• Amber T. Reeves, P.T.
• Renal Treatment Centers-Southeast, LP. (Pendleton Dialysis)
• Creseda Riccardi

• Dentist in Pendleton, SC
• Providers in Pendleton, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.