Carmen Villasante Graves, D.D.S, M.S

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

021.002792 Issued in IL

Practice address

850 S Wabash Ave Ste 240
Chicago, IL 60605-3643

Phone

(312) 356-4700

NPI assigned

Jun 11, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Carmen Nora Villasante Mercado Former name

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1437597598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 S WABASH AVE STE 240",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053643",
            "telephone_number": "312-356-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 S WABASH AVE STE 240",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053643",
            "telephone_number": "312-356-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "CARMEN",
        "middle_name": "VILLASANTE",
        "name_prefix": "Dr.",
        "credential": "D.D.S, M.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-11",
        "last_updated": "2022-06-06",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "019.031010",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "32052",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "ZZ",
            "license": "22154",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "021.002792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARMEN",
            "last_name": "VILLASANTE MERCADO",
            "middle_name": "NORA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Natalie Graunke, DPT, PT
• Jennifer Graus, LCPC
• Raigardas Antanas Grauzinis, DNP
• Melissa Beth Graver, AMFT, APCC
• Allyson Graves, RD, LDN, MPH
• Dexter Charles Graves, MD
• Elizabeth Michelle Graves, D.C.
• Joseph Andrew Graves, M.D.
• Kelly Graves, LCSW
• Monique Graves, APN

• Periodontics in Chicago, IL
• Providers in Chicago, IL by specialty
• Periodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.