Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

PRAMOD TADAKAMALLA DDS
NPI 1629591854
Dentist - General Practice in Peoria, IL

Active since July 19, 2017
3510 N UNIVERSITY ST STE C, PEORIA, IL 61604(309) 271-7777(309) 324-5777 Get Directions Write a Review

NPPES record last updated: July 1, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Pramod Tadakamalla Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRAMOD TADAKAMALLA DDS (NPI 1629591854) is an individual general practice provider in Peoria, Illinois, licensed in Illinois (019031274) and active in the NPI registry since July 2017.

NPPES Registry Identity

NPI1629591854
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NamePRAMOD TADAKAMALLACredential: DDS
Location Address3510 N UNIVERSITY ST STE CPeoria, IL 61604-1348
Mailing Address3510 N University St Ste CPeoria, IL 61604-1348 · (309) 271-7777 · Fax (309) 324-5777
Fax(309) 324-5777
Sole ProprietorNo
Enumeration DateJuly 19, 2017
Last NPPES UpdateJuly 1, 2026
NPPES CertifiedJuly 1, 2026
NPI 1629591854 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License Licensed in IL · 019031274
Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Also ListedDentistTaxonomy 122300000X · License 019.031274 (IL)
3510 N UNIVERSITY ST STE C, Peoria, IL 61604

Accepted Insurance

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (General Practice)
3510 N UNIVERSITY ST STE C
PEORIA, IL 61604
Dentist (General Practice)
3510 N UNIVERSITY ST STE C
PEORIA, IL 61604

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pramod Tadakamalla's NPI number?

The NPI number for Pramod Tadakamalla is 1629591854. It was assigned to this individual provider in the NPPES registry on July 19, 2017.

Where is Pramod Tadakamalla located?

Pramod Tadakamalla practices at 3510 N University St Ste C, Peoria, IL 61604. The listed phone number is (309) 271-7777.

What is Pramod Tadakamalla's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Pramod Tadakamalla accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, BEST Life and Blue Cross and Blue Shield of Montana and 7 other insurers list Pramod Tadakamalla as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pramod Tadakamalla was last updated on July 1, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.