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DR. SUPRIYA KUMAR VADERHOBLI DDS
NPI 1336209626
Dentist in Pacifica, CA

Active since December 09, 2006Opted out of Medicare · through Sep 12, 2027
331 INVERNESS DR, PACIFICA, CA 94044(650) 359-1062 Get Directions Write a Review

NPPES record last updated: February 27, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Supriya Kumar Vaderhobli Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SUPRIYA KUMAR VADERHOBLI DDS (NPI 1336209626) is an individual dentist in Pacifica, California, licensed in California (50769) and active in the NPI registry since December 2006. She has opted out of Medicare through September 12, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1336209626
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameDR. SUPRIYA KUMAR VADERHOBLICredential: DDS
Location Address331 INVERNESS DRPacifica, CA 94044-1712
Mailing Address331 Inverness DrPacifica, CA 94044-1712 · (650) 359-1062
Phone(650) 359-1062
Sole ProprietorNo
Enumeration DateDecember 9, 2006
Last NPPES UpdateFebruary 27, 2008
✔ NPI 1336209626 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in CA · 50769
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
331 INVERNESS DR, Pacifica, CA 94044
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Other Names 1

Former Name (1)Supriya Kumar Dds

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Dr. Supriya Kumar Vaderhobli Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from September 12, 2015 through September 12, 2027.

Opt-Out Effective DateSeptember 12, 2015
Opt-Out In Effect ThroughSeptember 12, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94044 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$84.91 typical visit price
range $23.44 – $166.46
Typical copayment $21.22 (range $5.86 – $41.61)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Supriya Vaderhobli's NPI number?

The NPI number for Supriya Vaderhobli is 1336209626. It was assigned to this individual provider in the NPPES registry on December 9, 2006. The provider is also known as Supriya Kumar Dds.

Where is Supriya Vaderhobli located?

Supriya Vaderhobli practices at 331 Inverness Dr, Pacifica, CA 94044. The listed phone number is (650) 359-1062.

What is Supriya Vaderhobli's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Supriya Vaderhobli enrolled in Medicare?

No. Supriya Vaderhobli has opted out of Medicare through September 12, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Supriya Vaderhobli accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Humana and Renaissance Dental list Supriya Vaderhobli as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Supriya Vaderhobli was last updated on February 27, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.