Tadakamalla, Pramod

Tadakamalla, Pramod is an individual health care provider with primary practice located at 3510 N University St Ste C , Peoria IL 61604-1348. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Dentist. Dental Providers / General Practice is his primary health care specialty. Tadakamalla, Pramod can be contacted via phone (309) 271-7777.

Contact Information

Primary practice address
3510 N University St Ste C Peoria IL 61604-1348
Phone: (309) 271-7777
Fax: (309) 324-5777
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 019031274 Illinois
Dental Providers / Dentist 122300000X 019.031274 Illinois

Profile Details

NPI number 1629591854
LBN Legal business name Tadakamalla, Pramod
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2017
Last updated Jul 1st, 2026 - about 3 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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