Deepa Sridhar P.C

Primary specialty

DentistTaxonomy code 122300000X

License

019026471 Issued in IL

Legal business name

DEEPA SRIDHAR P.C

Doing business as

Placida

Practice address

217 S Bolingbrook Dr
Bolingbrook, IL 60440-2931

Phone

(630) 313-4918

Fax

(630) 626-4784

NPI assigned

Feb 11, 2015

Last updated

Feb 11, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Deepa Sridhar, DMDNPI 1336200450

Title

President

Phone

(630) 313-4918

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Placida Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Deepa Sridhar, DMD

  • General Practice Dentistry
  • Bolingbrook, IL
  • NPI 1336200450
  NPD (past) Authorized official

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

{
    "created_epoch": "1423612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423612800000",
    "number": "1659762631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 S BOLINGBROOK DR",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402931",
            "telephone_number": "630-313-4918",
            "fax_number": "630-626-4784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 S BOLINGBROOK DR",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402931",
            "telephone_number": "630-313-4918",
            "fax_number": "630-626-4784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEPA SRIDHAR P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-11",
        "last_updated": "2015-02-11",
        "status": "A",
        "authorized_official_last_name": "SRIDHAR",
        "authorized_official_first_name": "DEEPA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-313-4918",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019026471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9178432",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Placida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susan M Davis, ND, FNP-BC
• Victoria E Davis, DC
• Nicole Day
• Kristen Deangelis, MHS, CCC-SLP/L
• Ashley Decraene
• Abalaine Delapena, PHARM.D.
• Ryan Delcambre, DPT
• Delijan Surgical Assistants, Inc.
• Deliverrx LLC
• Sophia Deltoro, D.O

• Dentist in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.