Marissa Lauren Wadhwa, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.036407 Issued in IL

Practice address

1977 N Milwaukee Ave
Chicago, IL 60647-4338

Phone

(773) 840-5003

NPI assigned

Aug 26, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lakeview Smiles Edgewater LTD

  • Dental Clinic/Center
  • Chicago, IL
  • NPI 1700532470
  NPD (past)

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

{
    "created_epoch": "1756166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1003794983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N HUDSON AVE UNIT 1211",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606546702",
            "telephone_number": "847-219-1945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1977 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474338",
            "telephone_number": "773-840-5003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6351 N Broadway St Unit A",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606601401",
            "country_code": "US",
            "telephone_number": "312-584-0510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADHWA",
        "first_name": "MARISSA",
        "middle_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-26",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.036407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Wade
• Tremell Wade
• Vanessa Wade, DPT
• Cynthia Jean Waderlow, MSE,LCSW
• Anupama Natraj Wadhwa, MD
• Meenakshi Wadhwa, MS, RD, LDN
• Niki Ashwani Wadhwa, MD
• Geeta Wadhwani, MD
• Lalit Wadhwani, MD
• Nitin R Wadhwani, M.D.

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; 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.