Active NPI
Ratna Lalitha Vedullapalli
- General Practice Dentistry
- Chicago, IL
National Provider Identifier
1720217953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS037988
- Practice address
- 430 W Erie St
Ste St
Chicago, IL 60654-6914 - Phone
- (920) 838-1649
- NPI assigned
- Jul 9, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS037988 | PA | Primary |
Addresses
Primary practice location
430 W Erie St
Ste St
Chicago, IL 60654-6914
Mailing address
430 W Erie St
Ste St
Chicago, IL 60654-6914
Phone (920) 838-1649
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 |
|---|---|---|---|
| DS037988 | PA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247097600000",
"number": "1720217953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "430 W ERIE ST",
"address_2": "STE ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606546914",
"telephone_number": "920-838-1649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 W ERIE ST",
"address_2": "STE ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606546914",
"telephone_number": "920-838-1649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VEDULLAPALLI",
"first_name": "RATNA",
"middle_name": "LALITHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-09",
"last_updated": "2009-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS037988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.