Individual provider Active NPI

Swati Vellanki, DDS

  • General Practice Dentistry
  • Fredericksburg, VA
National Provider Identifier
1811174667
Registry record updated Jan 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401412004 Issued in VA
Practice address
3128 Cowan Blvd
Fredericksburg, VA 22401-4975
Phone
(540) 899-9511
Fax
(540) 786-1994
NPI assigned
Jan 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2008

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 0401412004 VA Primary

Addresses

Primary practice location

3128 Cowan Blvd
Fredericksburg, VA 22401-4975

Mailing address

3128 Cowan Blvd
Fredericksburg, VA 22401-4975
Phone (540) 899-9511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20150730014042 VA Order and Referring Only - DentistPractitioner - Dentist 9234443573

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Neibauer Dental Care Past Accepting new patients
Neibauer Dental Care, PC General Practice Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201046400000",
    "number": "1811174667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3128 COWAN BLVD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014975",
            "telephone_number": "540-899-9511",
            "fax_number": "540-786-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3128 COWAN BLVD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014975",
            "telephone_number": "540-899-9511",
            "fax_number": "540-786-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELLANKI",
        "first_name": "SWATI",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-23",
        "last_updated": "2008-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401412004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.