Active NPI
Kaanti Gowru, DDS
- Pediatric Dentistry
- Orland Park, IL
National Provider Identifier
1548908536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 021.003316
- Practice address
- 9111 W 151St St
Orland Park, IL 60462-3202 - Phone
- (408) 440-6440
- NPI assigned
- May 20, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 021.003316 | IL | Primary |
| Dentist | 122300000X | 2951000878 | MI |
Addresses
Primary practice location
9111 W 151St St
Orland Park, IL 60462-3202
Mailing address
9111 W 151St St
Orland Park, IL 60462-3202
Phone (708) 590-4422
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 |
|---|---|---|---|
| 2951000878 | MI | MD | Dentist |
| 021.003316 | IL | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757980800000",
"number": "1548908536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9111 W 151ST ST",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604623202",
"telephone_number": "708-590-4422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9111 W 151ST ST",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604623202",
"telephone_number": "408-440-6440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOWRU",
"first_name": "KAANTI",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-20",
"last_updated": "2025-09-16",
"certification_date": "2025-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "IL",
"license": "021.003316",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2951000878",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.