Individual provider Active NPI

Karthika Devi Gopagani

  • General Practice Dentistry
  • Naperville, IL
National Provider Identifier
1306681416
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.035119 Issued in IL
Practice address
1568 W Ogden Ave Ste 108
Naperville, IL 60540-4090
Phone
(630) 447-9997
NPI assigned
Jun 28, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 019.035119 IL Primary

Addresses

Primary practice location

1568 W Ogden Ave Ste 108
Naperville, IL 60540-4090

Mailing address

12549 S Kerry LN
Plainfield, IL 60585-9610
Phone (309) 703-5521

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
019.035119ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1306681416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12549 S KERRY LN",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605859610",
            "telephone_number": "309-703-5521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1568 W OGDEN AVE STE 108",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605404090",
            "telephone_number": "630-447-9997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOPAGANI",
        "first_name": "KARTHIKA",
        "middle_name": "DEVI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.035119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.