Individual provider Active NPI

Aarthi Raghavan, DMD

  • Dentist
  • Dekalb, IL
National Provider Identifier
1043767031
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019030890 Issued in IL
Practice address
2061 Sycamore Road
Dekalb, IL 60115
Phone
(815) 900-9833
NPI assigned
Sep 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019030890 IL Primary

Addresses

Primary practice location

2061 Sycamore Road
Dekalb, IL 60115

Mailing address

1708 Brookdale Rd
Apt 23
Naperville, IL 60563-2160
Phone (979) 324-7241

Other names 1

  • Aarthi Vijay Raghavan Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019030890ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Million Dollar Smiles Inc. Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1043767031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 BROOKDALE RD",
            "address_2": "APT 23",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632160",
            "telephone_number": "979-324-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2061 SYCAMORE ROAD",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "60115",
            "telephone_number": "815-900-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGHAVAN",
        "first_name": "AARTHI",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019030890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AARTHI",
            "last_name": "RAGHAVAN",
            "middle_name": "VIJAY",
            "credential": "DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Dekalb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; 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.