Individual provider Active NPI

Monisha Manish Chadda, DDS

  • Dentist
  • Orchard Lake, MI
National Provider Identifier
1629484530
Registry record updated Jul 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901021303 Issued in MI
Practice address
3777 Indian TRL
None
Orchard Lake, MI 48324-1626
Phone
(248) 703-6287
NPI assigned
Jul 11, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901021303 MI Primary

Addresses

Primary practice location

3777 Indian TRL
None
Orchard Lake, MI 48324-1626

Mailing address

3777 Indian TRL
None
Orchard Lake, MI 48324-1626
Phone (248) 703-6287

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160224001409 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9234434507

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901021303MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405036800000",
    "number": "1629484530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3777 INDIAN TRL",
            "address_2": "NONE",
            "city": "ORCHARD LAKE",
            "state": "MI",
            "postal_code": "483241626",
            "telephone_number": "248-703-6287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3777 INDIAN TRL",
            "address_2": "NONE",
            "city": "ORCHARD LAKE",
            "state": "MI",
            "postal_code": "483241626",
            "telephone_number": "248-703-6287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHADDA",
        "first_name": "MONISHA",
        "middle_name": "MANISH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-11",
        "last_updated": "2014-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Lake, MI

Sources for this page

Verify at the official NPI Registry.