Individual provider Active NPI

Roja Vemula, DDS

  • General Practice Dentistry
  • Sterling, VA
National Provider Identifier
1730503970
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401415080 Issued in VA
Practice address
107 E Holly Ave Ste 5
Sterling, VA 20164-5405
Phone
(703) 430-6655
Fax
(703) 430-6684
NPI assigned
Feb 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019030500 IL
General Practice Dentistry 1223G0001X 0401415080 VA Primary

Addresses

Primary practice location

107 E Holly Ave Ste 5
Sterling, VA 20164-5405

Mailing address

107 E Holly Ave Ste 5
Sterling, VA 20164-5405
Phone (703) 430-6655

Other practice location 1

107 E Holly Ave Ste 5
Sterling, VA 20164-5405
Phone (703) 430-6655

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
019030500ILMDGeneral Practice Dentistry
0401415080VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1391731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1730503970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 E HOLLY AVE STE 5",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201645405",
            "telephone_number": "703-430-6655",
            "fax_number": "703-430-6684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E HOLLY AVE STE 5",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201645405",
            "telephone_number": "703-430-6655",
            "fax_number": "703-430-6684"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 E Holly Ave Ste 5",
            "address_purpose": "LOCATION",
            "city": "Sterling",
            "state": "VA",
            "postal_code": "201645405",
            "country_code": "US",
            "telephone_number": "703-430-6655",
            "fax_number": "703-430-6684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VEMULA",
        "first_name": "ROJA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019030500",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401415080",
            "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 Mar 17, 2018; 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.