Sreevidya Bodapati, D.D.S., M.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

23468 Issued in TX

Practice address

12319 N Mopac Expy
Suite 160
Austin, TX 78758-2414

Phone

(512) 222-5721

NPI assigned

Aug 7, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Texas Periodontists PC

  • Periodontics
  • Austin, TX
  • NPI 1467132159
  NPD

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411603200000",
    "number": "1851582415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12319 N MOPAC EXPY",
            "address_2": "SUITE 160",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787582414",
            "telephone_number": "512-222-5721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12319 N MOPAC EXPY",
            "address_2": "SUITE 160",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787582414",
            "telephone_number": "512-222-5721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODAPATI",
        "first_name": "SREEVIDYA",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-07",
        "last_updated": "2014-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "23468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Clawson Boccieri, RPH
• Mark Bochey, MD
• Jenna Bock
• Stacy Melody Bockholt, LMFT-ASSOCIATE
• Dana Ann Bocock
• Drew Marie Bodden
• Nicolas Rodriguez Bodden
• Sara Bode, FNP-C
• Weeranun Dechyapirom Bode, M.D.
• Bodhi Leaf, PLLC

• Periodontics in Austin, TX
• Providers in Austin, TX by specialty
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.