DR. PRASANTH DOMMARAJU


Address: 3924 S Archer Ave, Chicago, IL 60632-1116
Phone: 7738197101

DR. PRASANTH DOMMARAJU (NPI# 1497317515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1497317515
Entity Type Individual
Full Name DR. PRASANTH DOMMARAJU
Credential DMD
Practice Address 3924 S Archer Ave
Chicago
IL 60632-1116
Practice Telephone 7738197101
Enumeration Date 2019-06-29
Last Update Date 2019-06-29
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223G0001X Dentist
Specialization: General Practice
019032098 IL Dental Providers

Office Location

Street Address 3924 S ARCHER AVE
City CHICAGO
State IL
Zip Code 60632-1116

Providers in the same zip code

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1104474790 Amanda Rose Dirnberger Nurse Practitioner 3229-43 W. 47th Pl., Chicago, IL 60632 2019-08-28
1982121042 Brown Archer Dental PC Dentist 4893 S Archer Ave, Chicago, IL 60632 2017-08-29
1538577085 Metrosmiles - Archer Heights Dental Dentist 5141 S Cicero Ave, Chicago, IL 60632 2014-07-29
1174955173 Thresholds Community/Behavioral Health 718-24 West 47th St, Chicago, IL 60632 2013-08-01
1659612570 Sapex Home Healthcare, Inc. In Home Supportive Care 4107 West 47th Street, Chicago, IL 60632 2013-03-04
1912275462 Dawn Marie Mackessy Pharmacist 5435 S. Kedzie Ave, Chicago, IL 60632 2011-12-12
1033494752 Molly Elizabeth Mcdermott Pharmacist District 222-walgreens, Chicago, IL 60632 2011-10-13
1780908434 Chicago Electrical Trauma Research Institute Specialist/Technologist, Other 4047 W. 40th Street, Chicago, IL 60632 2010-03-24
1265765218 4365 Archer Mri, LLC Clinic/Center 4365 South Archer Avenue, Chicago, IL 60632 2009-09-09
1295968121 Smile Lee Faces Dentist 4197 S Archer Ave, Chicago, IL 60632 2009-08-26
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Taxonomy Information

Taxonomy Code 1223G0001X
Grouping Dental Providers
Classification Dentist
Specialization General Practice

Taxonomy Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Notes: Source: Academy of General Dentistry

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1295340628 Karina Valentin Dentist 1534 N Oakley Blvd Apt 3f, Chicago, IL 60622-1783 2020-09-11
1679181895 Robert J Chacon Dentist 15 S Throop St Apt 206, Chicago, IL 60607-2522 2020-07-14
1629693304 Priyanka Sikka Dentist 300 W Grand Ave Apt 303, Chicago, IL 60654-7855 2020-06-09
1164045456 Yong Chang Dds PC. Dentist 3531 N Western Ave Unit B, Chicago, IL 60618-6025 2020-05-21
1699301358 Marcella Guzman P.C. Dentist 3236 W. Fullerton Ave., Chicago, IL 60647 2020-03-13
1831749944 Kenwood Dental Group Dentist 1335 E 87th St Ste A, Chicago, IL 60619-7036 2019-09-19
1508412875 Kamal Paresh Patel Dentist 1040 W Randolph St, Chicago, IL 60607-2215 2019-08-13
1003469636 Ahmed Mansour Dentist 2122 N Milwaukee Ave Ste 1, Chicago, IL 60647-4251 2019-07-23
1568024925 John Michael Burnheimer II Dentist 11 S Green St Unit 1106, Chicago, IL 60607-1031 2019-07-05
1528629656 Teny Matavoosi Dentist 7110 W Archer Ave, Chicago, IL 60638-2204 2019-06-28
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Competitor

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City CHICAGO
Zip Code 60632

Improve Information

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Dataset Information

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.

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