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KEDZIE DENTISTRY LLC
NPI 1871455832
Dentist - General Practice in Chicago, IL

Active since November 28, 2025
5430 S KEDZIE AVE, CHICAGO, IL 60632(773) 295-2523 Get Directions Write a Review

NPPES record last updated: November 28, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kedzie Dentistry Llc NPPES

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

KEDZIE DENTISTRY LLC (NPI 1871455832) is a healthcare organization registered as a general practice in Chicago, Illinois and active in the NPI registry since November 2025. The organization lists Prasanth Dommaraju, Director, as its authorized official.

NPPES Registry Identity

NPI1871455832
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameKEDZIE DENTISTRY LLC
Location Address5430 S KEDZIE AVEChicago, IL 60632-2620
Mailing Address5430 S Kedzie AveChicago, IL 60632-2620 · (773) 295-2523
Phone(773) 295-2523
Organization SubpartNo
Authorized OfficialPrasanth DommarajuDirector · (630) 247-7216
Enumeration DateNovember 28, 2025
NPPES CertifiedNovember 28, 2025
✔ NPI 1871455832 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
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
Also ListedDentist · Orthodontics and Dentofacial OrthopedicsTaxonomy 1223X0400X
5430 S KEDZIE AVE, Chicago, IL 60632
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

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

OTILIO MELERO MDSC
Family Medicine
5430 S KEDZIE AVE
CHICAGO, IL 60632
Cook County (773) 471-2411
DENTAL IMPRESSION, SC
Dentist
5430 S KEDZIE AVE
CHICAGO, IL 60632
Cook County (773) 925-0650
SHAFEEQ H. BADER, D.D.S., S.C.
Dentist
5430 S KEDZIE AVE
CHICAGO, IL 60632
Cook County (773) 925-0650
LHM PHYSICAL THERAPY, INC.
Clinic/Center (Physical Therapy)
5430 S KEDZIE AVE
CHICAGO, IL 60632
Cook County (630) 826-5900
SURABHI JAITHLIYA
Student in an Organized Health Care Education/Training Program
5430 S KEDZIE AVE
CHICAGO, IL 60632
Cook County (773) 295-2523

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 Kedzie Dentistry LLC's NPI number?

The NPI number for Kedzie Dentistry LLC is 1871455832. It was assigned to this organization in the NPPES registry on November 28, 2025.

Where is Kedzie Dentistry LLC located?

Kedzie Dentistry LLC is located at 5430 S Kedzie Ave, Chicago, IL 60632. The listed phone number is (773) 295-2523.

What is Kedzie Dentistry LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Kedzie Dentistry LLC was last updated on November 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.