Active NPI
Sravani Thikkavarapu, DDS
- Dentist
- Aurora, IL
National Provider Identifier
1477070233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019.031306
- Practice address
- 1264B N Lake St
Aurora, IL 60506-2453 - Phone
- (630) 801-9028
- NPI assigned
- Aug 23, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.031306 | IL | Primary |
Addresses
Primary practice location
1264B N Lake St
Aurora, IL 60506-2453
Mailing address
1264B N Lake St
Aurora, IL 60506-2453
Phone (716) 249-2737
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019.031306 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Dental Clinic, LLC | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- Aurora, IL
- NPI 1386815744
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503446400000",
"number": "1477070233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1264B N LAKE ST",
"city": "AURORA",
"state": "IL",
"postal_code": "605062453",
"telephone_number": "716-249-2737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1264B N LAKE ST",
"city": "AURORA",
"state": "IL",
"postal_code": "605062453",
"telephone_number": "630-801-9028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIKKAVARAPU",
"first_name": "SRAVANI",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-23",
"last_updated": "2017-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.031306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Aug 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.