Sahitya Chiramana, DMD

Individual provider Active NPI Dentist · Carbondale, IL

NPI 1669917449 · NPPES record last updated Nov 21, 2019

Key facts

NPI
1669917449
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
019.032434 (IL)
Practice address
402 S Lewis LN
Carbondale, IL 62901
Phone
(618) 519-9200
Fax
(618) 519-9375
NPI assigned
Jan 3, 2017
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
DS041086PAMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS041086 PA
Dentist 122300000X 019.032434 IL Yes

Addresses

Primary practice location

402 S Lewis LN
Carbondale, IL 62901

Mailing address

109 California Street
P O Box 577
Carterville, IL 62918-0577
Phone (618) 519-9200

Other practice location 1

242 S Highland Ave
suite 201
Pittsburgh, PA 15206-3937
Phone (412) 661-7316

Other practice location 2

242 S Highland Ave
suite 201
Pittsburgh, PA 15206-3937
Phone (412) 661-7316

Other providers in Carbondale, IL

All providers in Carbondale, IL · Dentist in Illinois

Sources for this page

Verify at the official NPI Registry.