Individual provider Active NPI

Hetal V Vaidya, D.D.S

  • General Practice Dentistry
  • Columbus, OH
National Provider Identifier
1821197229
Registry record updated Dec 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.026860 Issued in IL
Practice address
21 W Hubbard Ave
Columbus, OH 43215-1474
Phone
(614) 258-3880
Fax
(614) 252-5873
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2012

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 019.026860 IL Primary

Addresses

Primary practice location

21 W Hubbard Ave
Columbus, OH 43215-1474

Mailing address

CMR 442
Heidelberg Dental Activity Credentials Office
Apo, AE 09042

Other identifiers 1

IdentifierTypeStateIssuer
2982107MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20161206000893 OH Order and Referring Only - DentistPractitioner - Dentist 1153601380

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.026860ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356566400000",
    "number": "1821197229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "CMR 442",
            "address_2": "HEIDELBERG DENTAL ACTIVITY CREDENTIALS OFFICE",
            "city": "APO",
            "state": "AE",
            "postal_code": "09042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 W HUBBARD AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432151474",
            "telephone_number": "614-258-3880",
            "fax_number": "614-252-5873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAIDYA",
        "first_name": "HETAL",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2012-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.026860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2982107",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.