Active NPI
Pallavi Agarwal, DDS
- Dentist
- Lisle, IL
National Provider Identifier
1821336322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019029307
- Practice address
- 2783 Maple Ave
Lisle, IL 60532-3280 - Phone
- (630) 857-3444
- NPI assigned
- Jan 18, 2013
- Last updated
- Apr 25, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019029307 | IL | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
2783 Maple Ave
Lisle, IL 60532-3280
Mailing address
2783 Maple Ave
Lisle, IL 60532-3280
Phone (630) 857-3444
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160425001736 | IL | Order and Referring Only - Other (Non-Physician) | 7012216179 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019029307 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hare Krishna Dental PLLC | Current | Accepting new patients |
Locations
2783 Maple Ave
Lisle, IL 60532
Phone (630) 857-3444
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Steeple Run Family Dental
- General Practice Dentistry
- Lisle, IL
- NPI 1043947260
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650844800000",
"number": "1821336322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2783 MAPLE AVE",
"city": "LISLE",
"state": "IL",
"postal_code": "605323280",
"telephone_number": "630-857-3444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2783 MAPLE AVE",
"city": "LISLE",
"state": "IL",
"postal_code": "605323280",
"telephone_number": "630-857-3444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGARWAL",
"first_name": "PALLAVI",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-18",
"last_updated": "2022-04-25",
"certification_date": "2022-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019029307",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lisle, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.