Individual provider Active NPI

Haritha Nallaparaju, DMD

  • General Practice Dentistry
  • Effingham, IL
National Provider Identifier
1386296606
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.032280 Issued in IL
Practice address
900 W Temple Ave Ste 208
Effingham, IL 62401-2187
Phone
(217) 342-0211
Fax
(217) 342-0232
NPI assigned
Jul 16, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019.032280 IL Primary

Addresses

Primary practice location

900 W Temple Ave Ste 208
Effingham, IL 62401-2187

Mailing address

900 W Temple Ave Ste 208
Effingham, IL 62401-2187
Phone (217) 342-0211

Other practice location 1

6215 E State St
Rockford, IL 61108-2514
Phone (815) 399-7777

Other practice location 2

1905 W Springfield Ave
Champaign, IL 61821-3007
Phone (862) 231-5859 ext. 86223

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
019.032280ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Experts, LLC General Practice PastSince Jul 25, 2019 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: haritha.nallaparaju.1@9559.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1386296606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W TEMPLE AVE STE 208",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012187",
            "telephone_number": "217-342-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W TEMPLE AVE STE 208",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012187",
            "telephone_number": "217-342-0211",
            "fax_number": "217-342-0232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6215 E State St",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611082514",
            "country_code": "US",
            "telephone_number": "815-399-7777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1905 W Springfield Ave",
            "address_purpose": "LOCATION",
            "city": "Champaign",
            "state": "IL",
            "postal_code": "618213007",
            "country_code": "US",
            "telephone_number": "862-231-5859 x86223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NALLAPARAJU",
        "first_name": "HARITHA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-16",
        "last_updated": "2020-12-01",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.032280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Effingham, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.