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Individual
KEERTHI PRASANNA CHENNURI
Active
Individual
KEERTHI PRASANNA CHENNURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.037113
IL
1223G0001X
General Practice Dentistry
019037113
IL
1223G0001X
General Practice Dentistry
Primary
15016
NC
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
IL
Other
Enumeration date
04/09/2026
Last updated
10/08/2026
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