Individual provider Active NPI

Vinay Kumar Reddy Battula, DMD

  • Dentist
  • Springfield, MA
National Provider Identifier
1801174198
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1855826 Issued in MA
Practice address
1795 Main St
Ste 101
Springfield, MA 01103-1077
Phone
(254) 458-5871
NPI assigned
Aug 3, 2011
Last updated
Aug 12, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1855826 MA Primary
Dentist 122300000X 010677 CT

Addresses

Primary practice location

1795 Main St
Ste 101
Springfield, MA 01103-1077

Mailing address

505 Plantation St
Apt 121
Worcester, MA 01605-4333
Phone (254) 458-5871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20160126001060 MA Order and Referring Only - DentistPractitioner - Dentist 2264735265

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010677CTMDClinical Social Worker
DN1855826MAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1801174198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 PLANTATION ST",
            "address_2": "APT 121",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016054333",
            "telephone_number": "254-458-5871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1795 MAIN ST",
            "address_2": "STE 101",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011031077",
            "telephone_number": "254-458-5871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATTULA",
        "first_name": "VINAY KUMAR REDDY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-03",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1855826",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "010677",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.