Individual provider Active NPI

Vaidehi J Mehta, D.M.D.

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1841578085
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
31707 Issued in TX
Practice address
13037 Nacogdoches Rd
San Antonio, TX 78217-1960
Phone
(210) 654-8109
Fax
(210) 654-0034
NPI assigned
Jul 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 15151 MD
General Practice Dentistry 1223G0001X DS038823 PA
General Practice Dentistry 1223G0001X 31707 TX Primary

Addresses

Primary practice location

13037 Nacogdoches Rd
San Antonio, TX 78217-1960

Mailing address

13037 Nacogdoches Rd
San Antonio, TX 78217-1960
Phone (210) 654-8109

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20150602001988 MD Order and Referring Only - DentistPractitioner - Dentist 2961723937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31707TXMDPsychologist
DS038823PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Avp Dental PC Current Accepting new patients
VSV Dental PLLC General Practice CurrentSince Dec 22, 2020 Accepting new patients
Sna Dental PC CurrentSince Dec 27, 2020 Accepting new patients
Santo Lafoca, DMD General Practice Past Accepting new patients

Locations

13037 Nacogdoches Rd
San Antonio, TX 78217
Phone (210) 654-8109

Organizations & group practices 4

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": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1841578085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13037 NACOGDOCHES RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782171960",
            "telephone_number": "210-654-8109",
            "fax_number": "210-654-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13037 NACOGDOCHES RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782171960",
            "telephone_number": "210-654-8109",
            "fax_number": "210-654-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "VAIDEHI",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-21",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "15151",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS038823",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "31707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.