Healthcare Provider Details

I. General information

NPI: 1952741407
Provider Name (Legal Business Name): VENKATA SUSHMA CHAMARTHI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2013
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DAKOTA PEDIATRICS 3636 N. FIRST STREET, SUITE 120
FRESNO CA
93726
US

IV. Provider business mailing address

3636 N 1ST ST STE 120
FRESNO CA
93726-6818
US

V. Phone/Fax

Practice location:
  • Phone: 559-224-4365
  • Fax:
Mailing address:
  • Phone: 559-224-4365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA148613
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: