Provider Demographics
NPI:1457488058
Name:PRAJAPATI, SNAHEL M (DMD)
Entity Type:Individual
Prefix:DR
First Name:SNAHEL
Middle Name:M
Last Name:PRAJAPATI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6638 N ARTESIAN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-5017
Mailing Address - Country:US
Mailing Address - Phone:773-203-0713
Mailing Address - Fax:
Practice Address - Street 1:6638 N ARTESIAN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-5017
Practice Address - Country:US
Practice Address - Phone:773-203-0713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO88481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO75833573Medicaid