Provider Demographics
NPI:1083392799
Name:ELANGO, AARTHI (DDS)
Entity Type:Individual
Prefix:DR
First Name:AARTHI
Middle Name:
Last Name:ELANGO
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 1:5507 CHARLTON RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-1671
Mailing Address - Country:US
Mailing Address - Phone:832-387-7094
Mailing Address - Fax:
Practice Address - Street 1:56 E 47TH ST UNIT 200
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60653-3818
Practice Address - Country:US
Practice Address - Phone:773-234-0777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190344431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice