Individual provider Active NPI

Sai L Kadiyala, DMD

  • General Practice Dentistry
  • Springfield, MA
National Provider Identifier
1982664173
Registry record updated May 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30-022297 Issued in OH
Practice address
367 Cooley Street
Springfield, MA 01128
Phone
(413) 796-1616
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30-022297 OH Primary

Addresses

Primary practice location

367 Cooley Street
Springfield, MA 01128

Mailing address

201 W 8TH St
Suite 810
Pueblo, CO 81003-3038
Phone (719) 562-4447

Other identifiers 1

IdentifierTypeStateIssuer
2628071MedicaidOH

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
30-022297OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274659200000",
    "number": "1982664173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W 8TH ST",
            "address_2": "SUITE 810",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033038",
            "telephone_number": "719-562-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "367 COOLEY STREET",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "01128",
            "telephone_number": "413-796-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADIYALA",
        "first_name": "SAI",
        "middle_name": "L",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2010-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-022297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2628071",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; 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.