Individual provider Active NPI

Davina Parathundil, DMD

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1023542909
Registry record updated Jul 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS041439 Issued in PA
Practice address
350 N Clark St Ste 600
C/O Kos Services, Attn: HR
Chicago, IL 60654-4782
Phone
(312) 274-4526
NPI assigned
Apr 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS041439 PA Primary

Addresses

Primary practice location

350 N Clark St Ste 600
C/O Kos Services, Attn: HR
Chicago, IL 60654-4782

Mailing address

350 N Clark St Ste 600
C/O Kos Services, Attn: HR
Chicago, IL 60654-4782

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181031001032 PA Practitioner - Dentist 2769754092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS041439PAMDGeneral Practice Dentistry

Interoperability endpoints

  • Direct secure messaging: davina.parathundildmd.p1@direct.gpha.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499990400000",
    "number": "1023542909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N CLARK ST STE 600",
            "address_2": "C/O KOS SERVICES, ATTN: HR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606544782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N CLARK ST STE 600",
            "address_2": "C/O KOS SERVICES, ATTN: HR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606544782",
            "telephone_number": "312-274-4526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARATHUNDIL",
        "first_name": "DAVINA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2017-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS041439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.