Individual provider Active NPI

Prasanna Guru, DMD

  • General Practice Dentistry
  • West Chester, OH
National Provider Identifier
1972887289
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.023587 Issued in OH
Practice address
5900 W Chester Rd Ste a
West Chester, OH 45069-2951
Phone
(513) 942-8181
NPI assigned
Oct 5, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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 30.023587 OH Primary

Addresses

Primary practice location

5900 W Chester Rd Ste a
West Chester, OH 45069-2951

Mailing address

4582 Wyndtree Dr Apt 175
West Chester, OH 45069-8749
Phone (617) 901-6854

Other practice location 1

950 N. Bridge St Unit D
Chillicothe, OH 45601
Phone (740) 773-7411

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
30.023587OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Pike Family Dentistry General Practice PastSince Sep 5, 2021 Accepting new patients
West Chester Dental Group General Practice PastSince Sep 5, 2021 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": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1972887289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4582 WYNDTREE DR APT 175",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450698749",
            "telephone_number": "617-901-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 W CHESTER RD STE A",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450692951",
            "telephone_number": "513-942-8181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "950 N. Bridge St Unit D",
            "address_purpose": "LOCATION",
            "city": "Chillicothe",
            "state": "OH",
            "postal_code": "45601",
            "country_code": "US",
            "telephone_number": "740-773-7411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GURU",
        "first_name": "PRASANNA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-05",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.023587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.