Individual provider Active NPI

Sindhu Devanaboyina

  • Dentist
  • Modesto, CA
National Provider Identifier
1922810183
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
111175 Issued in CA
Practice address
1404 Mitchell Rd
Modesto, CA 95351-4901
Phone
(209) 537-7878
NPI assigned
Jan 24, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 111175 CA Primary

Addresses

Primary practice location

1404 Mitchell Rd
Modesto, CA 95351-4901

Mailing address

1363 N Victor St Unit 408
Aurora, CO 80011-7087
Phone (469) 803-6838

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

LicenseStateTypeSpecialty
111175CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Satyen Desai Dental Corporation CurrentSince Jan 26, 2025 Accepting new patients

Locations

1404 Mitchell Rd
Modesto, CA 95351
Phone (209) 537-7878

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.

NPI Registry JSON

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

{
    "created_epoch": "1737676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1922810183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1363 N VICTOR ST UNIT 408",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800117087",
            "telephone_number": "469-803-6838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 MITCHELL RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953514901",
            "telephone_number": "209-537-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVANABOYINA",
        "first_name": "SINDHU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-24",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "111175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.