Active NPI
Vidyadhari Yarlagadda
- General Practice Dentistry
- Dallas, TX
National Provider Identifier
1902327166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6961
- Practice address
- 3030 Lyndon B Johnson Fwy Ste 1400
Dallas, TX 75234-2766 - Phone
- (972) 663-5301
- NPI assigned
- Jun 28, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6961 | OK | Primary |
Addresses
Primary practice location
3030 Lyndon B Johnson Fwy Ste 1400
Dallas, TX 75234-2766
Mailing address
8609 Naomi St
Plano, TX 75024-7804
Phone (954) 670-4499
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171023000186 | OK | Order and Referring Only - Dentist | 0446526396 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6961 | OK | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598227200000",
"number": "1902327166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8609 NAOMI ST",
"city": "PLANO",
"state": "TX",
"postal_code": "750247804",
"telephone_number": "954-670-4499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3030 LYNDON B JOHNSON FWY STE 1400",
"city": "DALLAS",
"state": "TX",
"postal_code": "752342766",
"telephone_number": "972-663-5301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YARLAGADDA",
"first_name": "VIDYADHARI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-28",
"last_updated": "2020-08-24",
"certification_date": "2020-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OK",
"license": "6961",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; 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.