Provider Demographics
NPI:1073674180
Name:NARASIMHAN, MEERA (DDS)
Entity Type:Individual
Prefix:
First Name:MEERA
Middle Name:
Last Name:NARASIMHAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:496 W ARMY TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-9366
Mailing Address - Country:US
Mailing Address - Phone:630-221-1577
Mailing Address - Fax:630-221-1567
Practice Address - Street 1:26W136 WATERBURY CT
Practice Address - Street 2:SUITE 109
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-1306
Practice Address - Country:US
Practice Address - Phone:646-373-7477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2013-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190268261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9180081Medicaid