Healthcare Provider Details

I. General information

NPI: 1164223384
Provider Name (Legal Business Name): SAITHEJA GADDE DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5550 TOUHY AVE STE 303
SKOKIE IL
60077-3254
US

IV. Provider business mailing address

5550 TOUHY AVE STE 303
SKOKIE IL
60077-3254
US

V. Phone/Fax

Practice location:
  • Phone: 847-780-2114
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number019036185
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: