Individual provider Active NPI

Neelima G Vadlapatla

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1972745313
Registry record updated Feb 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
25711 Issued in TX
Practice address
1420 W Mockingbird LN Ste 500
Dallas, TX 75247-6971
Phone
(214) 630-7080
Fax
(214) 630-7085
NPI assigned
Mar 31, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 54917 CA
General Practice Dentistry 1223G0001X 25711 TX Primary

Addresses

Primary practice location

1420 W Mockingbird LN Ste 500
Dallas, TX 75247-6971

Mailing address

1420 W Mockingbird LN Ste 500
Dallas, TX 75247-6971
Phone (214) 630-7080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20170426002684 TX Order and Referring Only - DentistPractitioner - Dentist 7214214394

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25711TXMDPharmacist
54917CAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1238457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328140800000",
    "number": "1972745313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 W MOCKINGBIRD LN STE 500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752476971",
            "telephone_number": "214-630-7080",
            "fax_number": "214-630-7085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 W MOCKINGBIRD LN STE 500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752476971",
            "telephone_number": "214-630-7080",
            "fax_number": "214-630-7085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VADLAPATLA",
        "first_name": "NEELIMA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-31",
        "last_updated": "2012-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "54917",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "25711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.