Individual provider Active NPI

Priya Chandrasekaran, DDS

  • General Practice Dentistry
  • Springfield, MA
National Provider Identifier
1982853917
Registry record updated Dec 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22316 Issued in MA
Practice address
376 Cooley St
Five Town Plaza
Springfield, MA 01128-1144
Phone
(413) 796-1616
NPI assigned
Sep 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2010

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 22316 MA Primary

Addresses

Primary practice location

376 Cooley St
Five Town Plaza
Springfield, MA 01128-1144

Mailing address

201 W 8TH St
Suite 810
Pueblo, CO 81003-3038
Phone (719) 562-4447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221230001385 CO Practitioner - Dentist 4284995986 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22316MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Community Provider Network Inc Current Accepting new patients
Metro Community Provider Network Inc CurrentSince Sep 17, 2022 Accepting new patients
Metro Community Provider Network, Inc. CurrentSince Sep 17, 2022 Accepting new patients

Locations

2255 S Oneida St
Denver, CO 80224

17866 Cottonwood Dr
Parker, CO 80134
Phone (303) 205-6899

Organizations & group practices 3

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": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293408000000",
    "number": "1982853917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W 8TH ST",
            "address_2": "SUITE 810",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033038",
            "telephone_number": "719-562-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "376 COOLEY ST",
            "address_2": "FIVE TOWN PLAZA",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011281144",
            "telephone_number": "413-796-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDRASEKARAN",
        "first_name": "PRIYA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-15",
        "last_updated": "2010-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "22316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.