Active NPI
Samidha Rajora, DDS
- Dentist
- Champaign, IL
National Provider Identifier
1972286979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019.034522
- Practice address
- 703 B S Neil St
Champaign, IL 61820 - Phone
- (857) 210-9497
- NPI assigned
- Aug 8, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.034522 | IL | Primary |
Addresses
Primary practice location
703 B S Neil St
Champaign, IL 61820
Mailing address
703B S Neil St
Champaign, IL 61820
Phone (857) 210-9497
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 |
|---|---|---|---|
| 019.034522 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691452800000",
"number": "1972286979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "703B S NEIL ST",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "61820",
"telephone_number": "857-210-9497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "703 B S NEIL ST",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "61820",
"telephone_number": "857-210-9497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAJORA",
"first_name": "SAMIDHA",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-08",
"last_updated": "2023-08-08",
"certification_date": "2023-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.034522",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.