Triveni Vilas Padale, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D011824 Issued in AZ

Practice address

17018 W Bell Rd
Surprise, AZ 85374-2433

Phone

(623) 214-1708

NPI assigned

Jun 12, 2023

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 CA

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.

• Canyon Modern Dentistry & Orthodontics

  • Dental Clinic/Center
  • Surprise, AZ
  • NPI 1366848897
  NPD (past)

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

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1932883048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17081 W GREENWAY RD STE 120",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853889612",
            "telephone_number": "623-546-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17018 W BELL RD",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742433",
            "telephone_number": "623-214-1708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADALE",
        "first_name": "TRIVENI VILAS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D011824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karina Osuna
• Carl W Otte, D.O.
• Oxford Integrated Health Solutions PLLC
• Amanda Christine Pace-Ellibee, RN
• Ashtyn Pace
• Destiny Padilla
• Ashley Paez
• Sarah Jane Paikowsky, OD
• Danielle Palacios
• Palm Vein Center LLC

• General Practice Dentistry in Surprise, AZ
• Providers in Surprise, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.