Individual provider Active NPI

Urvi Ravindran, DDS

  • Dentist
  • Chicago, IL
National Provider Identifier
1336301670
Registry record updated Jun 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019027693 Issued in IL
Practice address
5930 N Broadway St
Chicago, IL 60660-3519
Phone
(773) 878-2970
NPI assigned
Jun 27, 2008
Last updated
Jun 27, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019027693 IL Primary

Addresses

Primary practice location

5930 N Broadway St
Chicago, IL 60660-3519

Mailing address

1645 W Ogden Ave
Unit 408
Chicago, IL 60612-4199
Phone (312) 829-1286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20160627002650 NC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1456642198

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019027693ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1336301670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 W OGDEN AVE",
            "address_2": "UNIT 408",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124199",
            "telephone_number": "312-829-1286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5930 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606603519",
            "telephone_number": "773-878-2970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVINDRAN",
        "first_name": "URVI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-27",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.