Active NPI
Srujana Eluri, D.D.S
- Dentist
- Chicago, IL
National Provider Identifier
1477974376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DSO39833
- Practice address
- 350 N Clark St,
Ste 600 Kos Services Attn Juliette
Chicago, IL 60657-0092 - Phone
- (302) 438-4063
- NPI assigned
- Dec 18, 2013
- 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 | DSO39833 | PA | Primary |
Addresses
Primary practice location
350 N Clark St,
Ste 600 Kos Services Attn Juliette
Chicago, IL 60657-0092
Mailing address
938 Chester Pike
Sharon Hill, PA 19079-1413
Phone (610) 586-6520
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170306002222 | PA | Order and Referring Only - Dentist | 5991089203 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DSO39833 | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554076800000",
"number": "1477974376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "938 CHESTER PIKE",
"city": "SHARON HILL",
"state": "PA",
"postal_code": "190791413",
"telephone_number": "610-586-6520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 N CLARK ST,",
"address_2": "STE 600 KOS SERVICES ATTN JULIETTE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606570092",
"telephone_number": "302-438-4063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELURI",
"first_name": "SRUJANA",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-18",
"last_updated": "2019-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DSO39833",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; 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.