MEDICARE: CHANDRASHEKHAR PLLC

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)
2	1223X2210X	Orofacial Pain Dentistry

General Provider Information

NPI Number	:	1649165572
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHANDRASHEKHAR PLLC

Provider Business Mailing Address
First Line	:	509 OLIVE WAY STE 618
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98101-1761
Country	:	US
Telephone Number	:	206-880-0119
Fax Number	:	888-830-6339

Provider Business Practice Location Address
First Line	:	509 OLIVE WAY STE 618
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98101-1761
Country	:	US
Telephone Number	:	206-880-0119
Fax Number	:	888-830-6339

Authorized Official
Title or Position	:	OWNER
Name	:	HEMAMALINI CHANDRASHEKHAR
Credential	:
Telephone Number	:	206-880-0119

Provider Enumeration Date	:	06/11/2025
Last Update Date	:	12/08/2025

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