Vijaya KV Prabhu, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

38736 Issued in CA

Practice address

El Norte Family Dental.
306 W.El Norte Pkwy. Suite D & E
Escondido, CA 92026

Phone

(760) 480-5600

Fax

(760) 480-5689

NPI assigned

Oct 5, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992891790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EL NORTE FAMILY DENTAL.",
            "address_2": "306 W.EL NORTE PKWY. SUITE D & E",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "92026",
            "telephone_number": "760-480-5600",
            "fax_number": "760-480-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EL NORTE FAMILY DENTAL.",
            "address_2": "306 W.EL NORTE PKWY. SUITE D & E",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "92026",
            "telephone_number": "760-480-5600",
            "fax_number": "760-480-5689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRABHU",
        "first_name": "VIJAYA",
        "middle_name": "KV",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MED-ICAL DENTAL PROGAM",
            "identifier": "38736",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Regina Poudel, M.D.
• Carrie L Poulson, LCSW
• Daria Pourbafrani
• Amber Lynn Powell, RADT, PEER SUPPORT
• Veena Prabhakar, D.O.
• Rodolfo Miguel Prado Hernandez
• Rachel Ann Pranger
• Nikole Renae Pratt
• Isabel Preciado
• Preferred Home Health Services

• General Practice Dentistry in Escondido, CA
• Providers in Escondido, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.