Individual provider Active NPI

Vishu Midha

  • Dentist
  • Yuba City, CA
National Provider Identifier
1740025048
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
110920 Issued in CA
Practice address
1877 Stabler Park Dr
Yuba City, CA 95993-5192
Phone
(530) 491-3638
NPI assigned
Jun 27, 2024
Last updated
Nov 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 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 110920 CA Primary

Addresses

Primary practice location

1877 Stabler Park Dr
Yuba City, CA 95993-5192

Mailing address

1877 Stabler Park Dr
Yuba City, CA 95993-5192
Phone (530) 491-3638

Other practice location 1

285 Cohasset Rd
Chico, CA 95926-5513
Phone (530) 342-6065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241121003315 CA Order and Referring Only - DentistPractitioner - Dentist 3173058567

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110920CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1740025048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1877 STABLER PARK DR",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959935192",
            "telephone_number": "530-491-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1877 STABLER PARK DR",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959935192",
            "telephone_number": "530-491-3638"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "285 Cohasset Rd",
            "address_purpose": "LOCATION",
            "city": "Chico",
            "state": "CA",
            "postal_code": "959265513",
            "country_code": "US",
            "telephone_number": "530-342-6065",
            "fax_number": "530-343-7769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIDHA",
        "first_name": "VISHU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "110920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuba City, CA

Sources for this page

Verify at the official NPI Registry.