Active NPI
Srikanth Cherukadu Vasalaa, DDS
- General Practice Dentistry
- San Antonio, TX
National Provider Identifier
1912285362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 27122
- Practice address
- 4622 W Commerce St Ste 108
San Antonio, TX 78237-1608 - Phone
- (210) 757-9915
- NPI assigned
- Aug 2, 2011
- Sex
- Male
- 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 | 27122 | TX | Primary |
Addresses
Primary practice location
4622 W Commerce St Ste 108
San Antonio, TX 78237-1608
Mailing address
6300 West Loop S Ste 650
Bellaire, TX 77401-2997
Phone (713) 663-7960
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 |
|---|---|---|---|
| 27122 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Texas Dental Associates, L.P. | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- San Antonio, TX
- NPI 1437473972
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312243200000",
"number": "1912285362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6300 WEST LOOP S STE 650",
"city": "BELLAIRE",
"state": "TX",
"postal_code": "774012997",
"telephone_number": "713-663-7960",
"fax_number": "713-349-8027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4622 W COMMERCE ST STE 108",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782371608",
"telephone_number": "210-757-9915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHERUKADU VASALAA",
"first_name": "SRIKANTH",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-08-02",
"last_updated": "2011-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "27122",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.