Individual provider Active NPI

Pratishtha Mishra, BDS, MDS, MS

  • Orofacial Pain Dentistry
  • Chicago, IL
National Provider Identifier
1477112043
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orofacial Pain DentistryTaxonomy code 1223X2210X
License
136.000287 Issued in IL
Practice address
801 S Paulina St
Chicago, IL 60612-7210
Phone
(312) 355-1229
NPI assigned
Jun 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orofacial Pain Dentistry 1223X2210X 136.000287 IL Primary
Dentist 122300000X 136.000287 IL

Addresses

Primary practice location

801 S Paulina St
Chicago, IL 60612-7210

Mailing address

801 S Paulina St
Chicago, IL 60612-7210
Phone (312) 996-7555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20190826003976 KY Practitioner - Dentist 9739417924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dominion Health and Fitness, IncGroup PAC ID 3274570908, 71 clinicians
University of KentuckyGroup PAC ID 3072425289, 778 clinicians

Practice addresses (Care Compare)

4862 Dickenson Hwy
PO Box 1810
Clintwood, VA 24228-1810

770 Rose St
Lexington, KY 40536-0297
Phone (859) 323-3368

Merit-based Incentive Payment System (MIPS)

Final score
88.76 of 100Reported as group
Quality
78.19
Promoting interoperability
100
Improvement activities
40
Cost
70.17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
9684KYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky CurrentSince Jul 17, 2019 Accepting new patients
University of Kentucky Dentist CurrentSince Jul 17, 2019 Accepting new patients

Locations

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

770 Rose St
Lexington, KY 40536
Phone (859) 323-3368

740 S Limestone
Lexington, KY 40536
Phone (859) 257-3533

Interoperability endpoints

  • Direct secure messaging: pmishra25333@ukhcdirect.org

Organizations & group practices 3

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": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1477112043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S PAULINA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127210",
            "telephone_number": "312-996-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S PAULINA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127210",
            "telephone_number": "312-355-1229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHRA",
        "first_name": "PRATISHTHA",
        "credential": "BDS, MDS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "IL",
            "license": "136.000287",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "136.000287",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.