Vasantha Lakshmi Pedarla, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2025022117 Issued in MO

Practice address

4955 S National Ave Unit a
Springfield, MO 65810-2989

Phone

(417) 886-1010

NPI assigned

Jun 23, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Missouri Dental Professionals, Richard Straus, DMD, PC

  • General Practice Dentistry
  • Springfield, MO
  • NPI 1467672519
  NPD (past)

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

{
    "created_epoch": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1962188136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10357 BOSWELL DR",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750352496",
            "telephone_number": "816-389-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 S NATIONAL AVE UNIT A",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658102989",
            "telephone_number": "417-886-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDARLA",
        "first_name": "VASANTHA LAKSHMI",
        "name_prefix": "Ms.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-23",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2025022117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STUDENT IN AN ORGANIZED HEALTH CARE EDUCATION/TRAINING PROGRAM",
            "identifier": "1962188136",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas C Pearson, M.D.
• Judith Peavey
• Rebekah Linn Peavler, LMT
• Sher Peck
• Tracie M. Peck, M.A., CCC-SLP
• Pediatric Associates of Springfield, Inc.
• Pediatrics North Glenstone LLC
• Pediatrix Medical Group of Springfield
• Pediatrix Medical Group of Springfield
• Pediatrix Medical Group of Springfield

• General Practice Dentistry in Springfield, MO
• Providers in Springfield, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.