MEDICARE: CHAITANYA CHAPPIDI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	RES.004863	OH

General Provider Information

NPI Number	:	1407746209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAITANYA CHAPPIDI

Provider Business Mailing Address
First Line	:	32107 HAMILTON CT APT 105
Second Line	:
City	:	SOLON
State	:	OH
Zip	:	44139-5732
Country	:	US
Telephone Number	:	440-485-9298
Fax Number	:

Provider Business Practice Location Address
First Line	:	3701 LORAIN AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-3707
Country	:	US
Telephone Number	:	216-778-4725
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2025
Last Update Date	:	07/04/2025

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Directions to “ CHAITANYA CHAPPIDI ” Practice Location

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