Kavitha Chadhalavada

Primary specialty

DentistTaxonomy code 122300000X

License

DS037335 Issued in PA

Practice address

6554 Lebanon Ave
Philadelphia, PA 19151-3328

Phone

(215) 878-0058

NPI assigned

Oct 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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.

• Northeastern Dentistry @ Overbrook

  • General Practice Dentistry
  • Philadelphia, PA
  • NPI 1699073239
  NPD (past) Authorized official
• Northeastern Dentistry at Bellmawr LLC

  • General Practice Dentistry
  • Bellmawr, NJ
  • NPI 1467130666
  NPD

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1295924736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 SUMMIT RD",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080544748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6554 LEBANON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191513328",
            "telephone_number": "215-878-0058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 Creek Road",
            "address_purpose": "LOCATION",
            "city": "BellMawr",
            "state": "NJ",
            "postal_code": "08031",
            "country_code": "US",
            "telephone_number": "856-368-2554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHADHALAVADA",
        "first_name": "KAVITHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-22",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS037335",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02371000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daria Chacon, MD
• Laura Claire Chacon
• Chad Home Health Agency Inc
• Chad Home Health Agency, Inc.
• Madeline A Chadehumbe, MD
• Jae Min Chae, DMD
• Rebecca Chae
• Rebecca Chafetz
• Ross S Chafetz
• Jason Scott Chaffin

• Dentist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.