Active NPI
Elizabeth Paulkate Vaidyan, D.M.D
- Pediatric Dentistry
- Sunnyvale, TX
National Provider Identifier
1902157100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 39762
- Practice address
- 381 Arbor Mill CT
Sunnyvale, TX 75182-0053 - Phone
- (215) 703-8530
- NPI assigned
- Sep 27, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS039360 | PA | |
| Pediatric Dentistry | 1223P0221X | 39762 | TX | Primary |
Addresses
Primary practice location
381 Arbor Mill CT
Sunnyvale, TX 75182-0053
Mailing address
381 Arbor Mill CT
Sunnyvale, TX 75182-0053
Phone (215) 703-8530
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS039360 | PA | MD | Dentist |
| 39762 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689206400000",
"number": "1902157100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "381 ARBOR MILL CT",
"city": "SUNNYVALE",
"state": "TX",
"postal_code": "751820053",
"telephone_number": "215-703-8530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "381 ARBOR MILL CT",
"city": "SUNNYVALE",
"state": "TX",
"postal_code": "751820053",
"telephone_number": "215-703-8530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAIDYAN",
"first_name": "ELIZABETH",
"middle_name": "PAULKATE",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-27",
"last_updated": "2023-07-13",
"certification_date": "2023-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS039360",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "39762",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sunnyvale, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.