Chandni Proothi, DMD
Individual provider Active NPI General Practice Dentistry · Waukesha, WI
NPI 1124884358 · NPPES record last updated Oct 2, 2024
Key facts
- NPI
- 1124884358
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 6001673-15 (WI)
- Practice address
- 444 W Sunset Dr
Waukesha, WI 53189-7407 - Phone
- (262) 232-8461
- NPI assigned
- Feb 26, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6001673-15 | WI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental 360 Waukesha LLC | General Practice | Current |
Accepting new patients |
Locations
444 W Sunset Dr
Waukesha, WI 53189
Phone (262) 232-8461
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | 6001673-15 | WI | Yes |
Addresses
Primary practice location
444 W Sunset Dr
Waukesha, WI 53189-7407
Mailing address
777 N Van Buren St Apt 2011
Milwaukee, WI 53202-3862
Phone (929) 527-0828
Other providers in Waukesha, WI
- Prohealth Medical Group Inc
- Prohealth Medical Group Inc
- Prohealth Medical Group Inc
- Prohealth Medical Group Inc.
- Prohealth Waukesha Memorial Hospital, Inc.
- Proven Dental LLC
- Genevieve Puffer
- Kathleen Pugh
- Elisa Puls
- Laura Lynn Pulsifer
All providers in Waukesha, WI · General Practice Dentistry in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.