DR. CARMEN VILLASANTE GRAVES (NPI# 1437597598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437597598 |
| Entity Type | Individual |
| Full Name | DR. CARMEN VILLASANTE GRAVES |
| Other Name | CARMEN NORA VILLASANTE MERCADO |
| Credential | D.D.S, M.S |
| Practice Address |
Rm.458 Mc 859 801 S. Paulina St Chicago IL 60612 |
| Practice Telephone | 7736809136 |
| Mailing Telephone | 7736809136 |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2018-09-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
021.002792 | IL | Dental Providers |
| N | 1223P0300X |
Dentist Specialization: Periodontics |
019.031010 | IL | Dental Providers |
| N | 1223P0300X |
Dentist Specialization: Periodontics |
32052 | TX | Dental Providers |
| N | 1223P0300X |
Dentist Specialization: Periodontics |
22154 | ZZ | Dental Providers |
| Street Address |
RM.458 MC 859 801 S. PAULINA ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1568080174 | Nastaran Ordoyo Haghani Rad | Student in an Organized Health Care Education/Training Program | 1950 W. Polk Street, Room 6203, Chicago, IL 60612 | 2020-07-09 |
| 1669090403 | Marianne Gagnon-konamna | Student in an Organized Health Care Education/Training Program | 1950 West Polk Street, Chicago, IL 60612 | 2020-07-08 |
| 1922625672 | Tanya Montgomery Nee Brown | Pediatrics | 1950 West Polk Street, Neonatal and Perinatal Department, Chicago, IL 60612 | 2020-06-29 |
| 1124643028 | Ashley Swan | Dentist | 801 S. Paulina St, Uic College of Dentistry - Endodontics Clinic, Chicago, IL 60612 | 2020-06-16 |
| 1831711381 | Baillie Anne Bronner | Obstetrics & Gynecology | 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 | 2020-05-07 |
| 1154942449 | Keisha Davell Cole | Case Manager/Care Coordinator | 612 S Western Ave Unit 1, Chicago, IL 60612 | 2020-04-28 |
| 1275153777 | Isac Lim | Student in an Organized Health Care Education/Training Program | 1234 S. Wells, Chicago, IL 60612 | 2020-04-24 |
| 1578183414 | Zachary Belden | Student in an Organized Health Care Education/Training Program | Uic Psychiatry Residency 912 S. Wood St., Rm 130b Npi-s (mc 913), Chicago, IL 60612 | 2020-04-21 |
| 1548880560 | Christina Nunez | Student in an Organized Health Care Education/Training Program | 801 S. Paulina Street, M/c 850, Chicago, IL 60612 | 2020-04-20 |
| Find all providers in zip 60612 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972145183 | Dental Dream Team Associates LLC Yetta Mccullom Sole Mbr | Dentist | 820 E 87th St Ste 201, Chicago, IL 60619-6256 | 2019-10-09 |
| 1508355678 | Periodontal Associates, LLP | Dentist | 845 N Michigan Ave Ste 940w, Chicago, IL 60611-2216 | 2018-05-04 |
| 1013304724 | Elliott T. Deweese | Dentist | 7447 W Talcott Ave., Suite 227, Chicago, IL 60631 | 2015-04-20 |
| 1417377417 | Kate Quinlin | Dentist | 939 W North Ave Ste 700, Chicago, IL 60642-7839 | 2014-04-17 |
| 1972781961 | Daniel M Weber | Dentist | 25 E Washington, #1125, Chicago, IL 60602 | 2008-02-01 |
| 1699809202 | Stephen P Russo | Dentist | 25 E. Washington St, Suite 1125, Chicago, IL 60602 | 2007-03-15 |
| 1366572802 | Christine M Gadia | Dentist | 223 W. Jackson Blvd, #1275, Chicago, IL 60606-6908 | 2007-03-06 |
| 1700915105 | Loyola M. Gleason | Dentist | 5945 S Pulaski Rd, Chicago, IL 60629-4550 | 2007-03-04 |
| 1790833192 | Thomas F. Schneider Jr. | Dentist | 4949 W Irving Park Rd Ste D, Chicago, IL 60641-2641 | 2007-01-08 |
| 1336219856 | Periodontics Ltd. | Dentist | 111 N Wabash Ave Ste 919, Chicago, IL 60602-1932 | 2006-11-09 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.