Individual provider Active NPI

Puja Vijay Chaudhari, DMD

  • Dentist
  • Chicago, IL
National Provider Identifier
1235810557
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019034389 Issued in IL
Practice address
530 W Barry Ave Apt 3F
Chicago, IL 60657-5408
Phone
(423) 933-4995
NPI assigned
Jul 28, 2023
Last updated
Aug 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019034389 IL Primary

Addresses

Primary practice location

530 W Barry Ave Apt 3F
Chicago, IL 60657-5408

Mailing address

530 W Barry Ave Apt 3F
Chicago, IL 60657-5408
Phone (423) 933-4995

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
019034389ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1235810557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 W BARRY AVE APT 3F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575408",
            "telephone_number": "423-933-4995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 W BARRY AVE APT 3F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575408",
            "telephone_number": "423-933-4995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAUDHARI",
        "first_name": "PUJA",
        "middle_name": "VIJAY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019034389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.