Individual provider Active NPI

Saila Sree Anumula, D.D.S

  • General Practice Dentistry
  • Joliet, IL
National Provider Identifier
1710176839
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.027521 Issued in IL
Practice address
10 S Larkin Ave
Joliet
Joliet, IL 60436-1243
Phone
(815) 773-6200
Fax
(815) 773-6201
NPI assigned
Oct 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019.027521 IL Primary

Addresses

Primary practice location

10 S Larkin Ave
Joliet
Joliet, IL 60436-1243

Mailing address

430 W Erie St
Ste 500,
Chicago, IL 60610-6914
Phone (312) 274-0308

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

LicenseStateTypeSpecialty
019.027521ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dream Smile Dental Inc Current Accepting new patients
Dental Experts, LLC General Practice Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1710176839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 W ERIE ST",
            "address_2": "STE 500,",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606106914",
            "telephone_number": "312-274-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 S LARKIN AVE",
            "address_2": "JOLIET",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604361243",
            "telephone_number": "815-773-6200",
            "fax_number": "815-773-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANUMULA",
        "first_name": "SAILA",
        "middle_name": "SREE",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-15",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.027521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; 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.