1427286798 NPI number — VASANTH RAJ DHARMARAJ D.D.S Table of Content • • • • •
Additional Information NPI Profile Modification General Information Detailed Information Driving Directions
Additional Information You can get information about the owner of the 1427286798 NPI number — VASANTH RAJ DHARMARAJ D.D.S in the and Text formats.
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General Information NPI Number Entity Type Code Provider Name (Legal Business Name)
: 1427286798 : Individual : VASANTH RAJ DHARMARAJ D.D.S
Provider Business Mailing Address First Line
: 430 W ERIE DENTAL DREAMS LLC
Second Line City State Zip Country
: : : : :
Telephone Number
:
Fax Number
:
SUITE 200 CHICAGO IL 60610 US 920-838-1649
920-838-1649 FREE
Provider Business Practice Location Address First Line : 430 W ERIE ST Second Line : SUITE - 200 City : CHICAGO State : IL Zip : 60654-6914 Country : US Telephone Number
:
Fax Number
:
920-838-1649
Authorized Official Title or Position Name Credential Telephone Number
: : : :
Provider Enumeration Date Last Update Date
: 06/25/2009 : 06/25/2009
920-838-1649 FREE
Detailed Information NPI Number 1427286798 has the “Individual” type of ownership and has been registered to the following primary business legal name (which is a provider name or healthcare organization name) — VASANTH RAJ DHARMARAJ D.D.S. Records indicate that the provider gender is “Male”. The enumeration date of this NPI Number is 06/25/2009. NPI Numer information was last updated at 06/25/2009. The provider is physically located (Business Practice Location) at: 430 W ERIE ST SUITE - 200 CHICAGO , IL 60654-6914 US The provider can be reached at his practice location using the following numbers:
Phone 920-838-1649 begin_of_the_skype_highlighting Fax The provider's official mailing address is: 430 W ERIE DENTAL DREAMS LLC SUITE 200 CHICAGO , IL 60610 US The contact numbers associated with the mailing address are:
920-838-1649 FREE end_of_the_skype_highlighting
Phone 920-838-1649 begin_of_the_skype_highlighting Fax
920-838-1649 FREE end_of_the_skype_highlighting
The authorized official registered with the “1427286798” NPI Number is . The authorized official title (position) is . You can reach the authorized official at the following phone number .
Scope of Practice The following information about the speciality of the provider is available:
# 1 #
Taxonomy Code 1223G0001X Field Name
Taxonomy
License Number
General Practice
DS037919
Value
1
NPI
1427286798
2
Entity Type
Individual
License Number State PA Description
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. Code describing the type of health care provider that is being assigned an NPI. Codes are: • 1 = (Person): individual human being who furnishes health care; •
2 = (Non-person): entity other than an individual human
being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3
Is Sole Proprietor
N
Indicate whether provider is a sole proprietor. • A sole proprietor is the sole (the only) owner of a business that is not incorporated; that unincorporated business is a sole proprietorship. • In a sole proprietorship, the sole proprietor owns all of the assets of the business and is solely liable for all of the debts of the business. • There is no difference between a sole proprietorship and a sole proprietor; they are legally a single entity: an individual. • In terms of NPI assignment, a sole proprietor is an Entity type 1 (Individual) and is eligible for only one NPI (the sole proprietorship business is not eligible for its own NPI). • As an individual, a sole proprietorship cannot be a subpart and cannot have subparts. (See NPI Final Rule for information about subparts.) • A sole proprietorship may or may not have employees. • Often, the IRS assigns an EIN to a sole proprietorship in order to protect the sole proprietor's SSN from disclosure in claims or on W-2s. NPPES does not capture a sole proprietorship's EIN. •
4
Provider Last Name (Legal Name)
DHARMARAJ
Many types of health care providers could be sole proprietorships (for example, group practices, pharmacies, home health agencies).
The last name of the provider (if an individual). If the provider is an individual, this is the legal name. This name must match the name on file with the Social Security Administration (SSA). In addition, the date of birth must match that on file with SSA. (First and last names
are required for initial applications.) The First, Middle, Last and Credential(s) fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. 5
6
Provider First Name Provider Credential Text
VASANTH RAJ
The first name of the provider, if the provider is an individual.
D.D.S
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
7
Provider First Line Business Mailing Address
430 W ERIE DENTAL DREAMS LLC
The first line mailing address of the provider being identified. This data element may contain the same information as ''Provider first line location address''.
Provider Second Line Business Mailing Address
SUITE 200
8
The second line mailing address of the provider being identified. This data element may contain the same information as ''Provider second line location address''.
9
Provider Business Mailing Address City Name
CHICAGO
The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''.
10
Provider Business Mailing Address State Name
IL
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''.
11
Provider Business Mailing Address Postal Code
60610
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ''Provider location address postal code''.
12
Provider Business Mailing Address Country Code
US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''.
13
Provider Business Mailing Address Telephone Number
14
Provider First Line Business Practice Location Address
15
Provider Second Line Business Practice Location
920-8381649 920838-1649 FREE
430 W ERIE ST
SUITE - 200
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ''Provider location address telephone number''.
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Address
16
Provider Business Practice Location Address City Name
CHICAGO
The city name in the location address of the provider being identified.
17
Provider Business Practice Location Address State Name
IL
The State or Province name in the location address of the provider being identified.
18
Provider Business Practice Location Address Postal Code
60654-6914
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
19
Provider Business Practice Location Address Country Code
US
The country code in the location address of the provider being identified.
20
Provider
920-838-
The telephone number associated with the location address of the
Business Practice Location Address Telephone Number
1649 920838-1649 FREE
provider being identified.
21
Provider Enumeration Date
06/25/2009
The date the provider was assigned a unique identifier (assigned an NPI).
22
Last Update Date
06/25/2009
The date that a record was last updated or changed.
23
Provider Gender Code
M
The code designating the provider's gender if the provider is a person.
24
Provider Gender
Male
The provider's gender if the provider is a person.
25
Healthcare Provider Taxonomy Code #1
1223G0001X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
26
Healthcare Provider Taxonomy 1
General Practice
Healthcare Provider Taxonomy #1
DS037919
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign
27
Provider License Number 1
Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
28
Provider License Number State Code 1
29
Healthcare Provider Primary Taxonomy Switch 1
PA
Y
Provider License Number State Code #1
Primary Taxonomy: • X - The primary taxonomy switch is Not Answered; • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record); •
N - The taxonomy is not the primary taxonomy.
Driving Directions to “ VASANTH RAJ DHARMARAJ D.D.S” Practice Location Language
Start Address San Diego
Practice Location 430 W ERIE ST SUITE - 200 CHICAGO IL 60654-6914
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results. San Diego, CA, USA 2,079 mi- about 1 day 6 hours 1.
Head south on 4th Ave toward Broadway
30 ft
2.
Turn left onto Broadway
0.4 mi
3.
Turn left onto 11th Ave
0.3 mi
4.
Continue onto CA-163 N
11.1 mi
5.
Merge onto I-15 N
50.6 mi
6.
Keep right to continue on I-215 N, follow signs for Riverside/San Bernardino
34.7 mi
7.
Keep right to stay on I-215 N, follow signs for Main St/Interstate 215 N/San Bernardino/Barstow
20.8 mi
8.
Merge onto I-15 N
455 mi
Passing through Nevada, Arizona Entering Utah
9.
Take exit 132 to merge onto I-70 E toward Richfield/Denver
501 mi
Entering Colorado
10.
Take exit 269B on the left to merge onto I-76 E toward Ft Morgan
187 mi
Entering Nebraska
11.
Merge onto I-80 E
660 mi
Passing through Iowa Entering Illinois
12.
Take exit 4B to merge onto I-88 E/IL-92 E toward Sterling/Rock Falls
141 mi
Continue to follow I-88 E Partial toll road
13.
Merge onto I-290 E
13.2 mi
14.
Take the I-90 W/I-94 W/Kennedy Expy W exit toward Wisconsin
0.6 mi
15.
Merge onto I-90 W/I-94 W/Kennedy Expy
0.9 mi
16.
Take exit 50B for Ohio St E
0.8 mi
17.
Turn left onto N Orleans St
0.1 mi
18.
Turn left onto W Erie St
0.1 mi
Destination will be on the right
430 West Erie Street #200, Chicago, IL 60654, USA Map data Š2014 Google, INEGI