NPIMap

Organization Active NPI

Dental Theory LTD

Doing business as city of lights dental

  • General Practice Dentistry
  • Aurora, IL
National Provider Identifier
1417657974
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL THEORY LTD
Doing business as
city of lights dental
Practice address
1940 W Galena Blvd Ste 11
Aurora, IL 60506-4483
Phone
(630) 892-7087
NPI assigned
Mar 3, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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

Authorized official

Name
Dr. Satish K Gottumukkula, DMDNPI 1316042690
Title
Owner
Phone
(630) 618-0882

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1940 W Galena Blvd Ste 11
Aurora, IL 60506-4483

Mailing address

1940 W Galena Blvd Ste 11
Aurora, IL 60506-4483
Phone (630) 892-7087

Other names 1

  • city of lights dental Doing business as

National Provider Directory

National Provider Directory

Locations

1940 W Galena Blvd
Ste 11
Aurora, IL 60506
Phone (630) 892-7087

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1677801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677801600000",
    "number": "1417657974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 W GALENA BLVD STE 11",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605064483",
            "telephone_number": "630-892-7087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 W GALENA BLVD STE 11",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605064483",
            "telephone_number": "630-892-7087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL THEORY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-03",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A",
        "authorized_official_last_name": "GOTTUMUKKULA",
        "authorized_official_first_name": "SATISH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-618-0882",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "city of lights dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; 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.