Malavika Prasanna, BDS,DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019028441 Issued in IL

Practice address

2537 W North Ave
Melrose Park, IL 60160-1121

Phone

(312) 274-0308

NPI assigned

Aug 3, 2010

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.

• Dental Experts, LLC

  • General Practice Dentistry
  • Melrose Park, IL
  • NPI 1780855775
  NPD (past)

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

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1104130038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 W ERIE ST",
            "address_2": "SUITE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606546914",
            "telephone_number": "920-838-1649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2537 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601121",
            "telephone_number": "312-274-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRASANNA",
        "first_name": "MALAVIKA",
        "name_prefix": "Dr.",
        "credential": "BDS,DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-03",
        "last_updated": "2010-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019028441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pipeline-Westlake Hospital, LLC
• Pipeline-Westlake Hospital, LLC
• Jorge R Poletti
• Justin Poole, PA-C
• Nathan Jon Porcher, D.C.
• Alexandra Marilyn Pratl, MOTR/L
• Presence Behavioral Health
• Presence Behavioral Health
• Presence Behavioral Health
• Presence Behavioral Health

• General Practice Dentistry in Melrose Park, IL
• Providers in Melrose Park, 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 Aug 3, 2010; 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.