DR. SURENDRA REDDY MANDAPATI (NPI# 1649893470) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649893470 |
| Entity Type | Individual |
| Full Name | DR. SURENDRA REDDY MANDAPATI |
| Credential | DDS |
| Practice Address |
3510 N University St Ste A Peoria IL 61604-1346 |
| Practice Telephone | 2032154687 |
| Mailing Telephone | 8177732088 |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2020-06-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019.032588 | IL | Dental Providers |
| Street Address |
3510 N UNIVERSITY ST STE A |
| City | PEORIA |
| State | IL |
| Zip Code | 61604-1346 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265926729 | Vogue Dental Peoria LLC | Dentist | 3510 N University St Ste A, Peoria, IL 61604-1346 | 2018-06-19 |
| 1578117768 | Juhi Dilipkumar Hirpara | Dentist | 3510 N University St Ste A, Peoria, IL 61604-1346 | 2019-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205357928 | Nydia I Rodriguez | Nurse's Aide | 3305 N Finnell Ave, Peoria, IL 61604 | 2017-07-03 |
| 1720327976 | Brin Diagnostics Inc. | Clinical Medical Laboratory | 3216 W Kenwood, West Peoria, IL 61604 | 2013-02-07 |
| 1225373715 | Ngocyen Thi Ngo | Pharmacist | 2515 N Knoxville Avenue, Peoria, IL 61604 | 2012-12-10 |
| 1194027003 | Schelly Chiropractic, Inc | Chiropractor | 1208 W Loucks, Peoria, IL 61604 | 2010-11-29 |
| 1770755852 | Dental Sealants & More | Dentist | 2126 N. University St., Peoria, IL 61604 | 2008-03-28 |
| 1821266123 | David L Krick | Dentist | 2022 N University, Peoria, IL 61604 | 2008-02-20 |
| 1568658409 | Advanced Physicians Health Care, S.c. | Chiropractor | 1200 West Loucks Ave, Peoria, IL 61604 | 2007-09-24 |
| 1902006000 | Noel Liu | Dentist | 3127 N. University St., Unit C, Peoria, IL 61604 | 2007-07-18 |
| 1568586386 | Susan B Bordenave-bishop | Dentist | 2116 N. Sheridan, Peoria, IL 61604 | 2007-03-19 |
| 1174689897 | Paul Anthony Amodeo | Dentist | 3100 N Dries Lane, Suite 301, Peoria, IL 61604 | 2006-12-28 |
| Find all providers in zip 61604 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013530187 | Core Family Dental, LLC | Dentist | 13460 N 94th Dr Ste K4, Peoria, AZ 85381-4249 | 2020-05-24 |
| 1982248084 | Westbrook Dental Center, P.a. | Dentist | 9276 W Union Hills Dr Ste A, Peoria, AZ 85382-8206 | 2019-10-31 |
| 1699318725 | Mint Dental Care LLC | Dentist | 8258 W Thunderbird Rd Ste 201, Peoria, AZ 85381-4777 | 2019-10-21 |
| 1548822497 | Katherine M Unes | Dentist | 11323 N Pawnee Rd, Peoria, IL 61615-9796 | 2019-07-01 |
| 1992296073 | George S Hariri | Dentist | 7777 W Deer Valley Rd Ste 160, Peoria, AZ 85382-2104 | 2018-05-23 |
| 1619485869 | Thunderbird Dental Studio | Dentist | 9179 W Thunderbird Rd Ste 107, Peoria, AZ 85381-4875 | 2018-01-22 |
| 1588179311 | Dr. Marc C Thevenin Jr. PC | Dentist | 5116 N Big Hollow Rd Ste 101, Peoria, IL 61615-3514 | 2017-12-01 |
| 1629592423 | Jessica Leigh Howard | Dentist | 7966 W Thunderbird Rd Ste 101, Peoria, AZ 85381-4902 | 2017-08-02 |
| 1588193718 | Darren Anderson | Dentist | 28451 N Vistancia Blvd Ste 101, Peoria, AZ 85383-2090 | 2017-06-10 |
| 1962943290 | Optim Dental Peoria-1 LLC | Dentist | 1200 W Main St Ste 9, Peoria, IL 61606-1218 | 2017-03-20 |
| Find all providers in PEORIA | ||||
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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.