Vivede Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

VIVEDE INC

Practice address

359 Keller Pkwy
Keller, TX 76248-2206

Phone

(817) 431-6995

NPI assigned

Oct 2, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Deepa Venugopal, DDS

Title

Ceo

Phone

(313) 549-1401

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Keller Parkway Dental Doing business as

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538438400000",
    "number": "1780169086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 CHERRY GLOW CT",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482034",
            "telephone_number": "313-549-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359 KELLER PKWY",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482206",
            "telephone_number": "817-431-6995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVEDE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-02",
        "last_updated": "2018-10-02",
        "status": "A",
        "authorized_official_last_name": "VENUGOPAL",
        "authorized_official_first_name": "DEEPA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-549-1401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS DENTAL LICENSE",
            "identifier": "30974",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keller Parkway Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Keller, TX
• Providers in Keller, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.