Individual provider Active NPI

Praneetha Vallamreddy, DDS

  • General Practice Dentistry
  • Copperas Cove, TX
National Provider Identifier
1740647999
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
31643 Issued in TX
Practice address
181 W Business 190
Suite 4
Copperas Cove, TX 76522-3671
Phone
(245) 987-6777
NPI assigned
Jan 19, 2016
Last updated
Jan 19, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 31643 TX Primary

Addresses

Primary practice location

181 W Business 190
Suite 4
Copperas Cove, TX 76522-3671

Mailing address

13883 E Richthofen Cir Apt H106
Aurora, CO 80011-6775
Phone (859) 494-3980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160707001007 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6002108339

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, 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": "1453161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1740647999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13883 E RICHTHOFEN CIR APT H106",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800116775",
            "telephone_number": "859-494-3980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 W BUSINESS 190",
            "address_2": "SUITE 4",
            "city": "COPPERAS COVE",
            "state": "TX",
            "postal_code": "765223671",
            "telephone_number": "245-987-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLAMREDDY",
        "first_name": "PRANEETHA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-19",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "31643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Copperas Cove, TX

Sources for this page

Verify at the official NPI Registry.