Prakash K. Upadhyaya DDS LTD.

Primary specialty

DentistTaxonomy code 122300000X

License

019015678 Issued in IL

Legal business name

PRAKASH K. UPADHYAYA DDS LTD.

Practice address

2400 W Roosevelt Rd
Suite #1
Broadview, IL 60155-3880

Phone

(708) 865-2400

NPI assigned

Apr 23, 2014

Organization subpart

Yes

Parent organization

PRAKASH K. UPADHYAYA DDS LTD.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Prakash K Upadhyaya, D.D.S.

Title

General Dentist

Phone

(708) 865-2400

Specialties & licenses 1

Addresses

Tax ID family

Prakash K Upadhyaya DDS LTD2 organizations share this tax ID, including this one

Part of

Prakash K Upadhyaya DDS LTD

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Prakash K Upadhyaya DDS LTD

  • Dentist
  • Chicago, IL
  • NPI 1225234313
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Prakash K Upadhyaya DDS LTD

  • Dentist
  • Chicago, IL
  • NPI 1225234313
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398211200000",
    "number": "1003236555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 W ROOSEVELT RD",
            "address_2": "SUITE #1",
            "city": "BROADVIEW",
            "state": "IL",
            "postal_code": "601553880",
            "telephone_number": "708-865-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 W ROOSEVELT RD",
            "address_2": "SUITE #1",
            "city": "BROADVIEW",
            "state": "IL",
            "postal_code": "601553880",
            "telephone_number": "708-865-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAKASH K. UPADHYAYA DDS LTD.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRAKASH K. UPADHYAYA DDS LTD.",
        "enumeration_date": "2014-04-23",
        "last_updated": "2014-04-23",
        "status": "A",
        "authorized_official_last_name": "UPADHYAYA",
        "authorized_official_first_name": "PRAKASH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "708-865-2400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019015678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenita J. Perry-Bell, L.C.S.W.
• David Phan, PHARMD
• Thomas Alan Plach, LCSW
• Britteny Poe
• Avery Polizzi
• Presence Behavioral Health
• Presence Behavioral Health
• Sarah Jean Prokop, PHARMD
• Brian Louis Raymond, PHARM. D.
• Erin Reynolds, APN

• All providers in Broadview, IL
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.