Chirdeep Mysore Chandrakeerthi, BDS, MSD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

10558 Issued in AZ

Practice address

7032 E Cochise Rd A220
Scottsdale, AZ 85253

Phone

(480) 443-8440

Fax

(480) 443-4767

NPI assigned

Oct 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

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.

• Periodonal Specialists

  • Periodontics
  • Scottsdale, AZ
  • NPI 1437296852
  NPD (past)

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1255528360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7032 E COCHISE RD A220",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85253",
            "telephone_number": "480-443-8440",
            "fax_number": "480-443-4767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7032 E COCHISE RD A220",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85253",
            "telephone_number": "480-443-8440",
            "fax_number": "480-443-4767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDRAKEERTHI",
        "first_name": "CHIRDEEP",
        "middle_name": "MYSORE",
        "name_prefix": "Dr.",
        "credential": "BDS, MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-02",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OR",
            "license": "D9020",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "GA",
            "license": "DN015335",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "10558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Bradley Chandler, CRNA
• Erynn Michelle Chandler, CRNA
• Julieanne Chandler, D.D.S.
• Aditi Thokala Chandra, DO
• Binoy Chandra, MD
• Isabela Wen-CHI Chang, MD
• Change Academy at Lake of the Ozarks
• Change Academy at Lake of the Ozarks
• Change Points Coaching and Consulting, LLC
• Changes Healing Center LLC

• Periodontics in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Periodontics in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.