Healthcare Provider Details

I. General information

NPI: 1366139065
Provider Name (Legal Business Name): VINAY KUMAR PILLY YADAIAH DDS, MPH, MSC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2023
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1395 US 183 140B
LEANDER TX
78641
US

IV. Provider business mailing address

1395 US 183 #140B
LEANDER TX
78641
US

V. Phone/Fax

Practice location:
  • Phone: 512-580-5378
  • Fax:
Mailing address:
  • Phone: 225-614-1727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number41343
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: