Sridevi Vijayasekaran, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00009476 Issued in WA

Practice address

1401 Marvin Rd NE Ste 302
Lacey, WA 98516-5710

Phone

(360) 459-8348

Fax

(360) 459-2919

NPI assigned

May 21, 2007

Sex

Female

Sole proprietor

No

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 WA

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

Practice roles

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.

• Broughton Dunn PLLC

  • General Practice Dentistry
  • Lacey, WA
  • NPI 1609781038
  NPD (past)

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912116567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2418 COOPER CREST DR NW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985024038",
            "telephone_number": "206-849-5739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MARVIN RD NE STE 302",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985165710",
            "telephone_number": "360-459-8348",
            "fax_number": "360-459-2919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIJAYASEKARAN",
        "first_name": "SRIDEVI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00009476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vest Thurston LLC
• Vest Thurston LLC
• Laura Vey-Ashby
• Zildjian M Viers
• Tracy Vigus, PHYSICAL THERAPIST
• Diosyl Villafuerte
• Andrew Juan Villapudua
• May Claire Legaspi Villegas, RN BSN PMHNP-BC
• Rachel Vind
• Nelia Vinluan

• General Practice Dentistry in Lacey, WA
• Providers in Lacey, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.