Provider Demographics
NPI:1124900766
Name:BETANAPALLI, PRAMEELARANI (DMD)
Entity type:Individual
Prefix:DR
First Name:PRAMEELARANI
Middle Name:
Last Name:BETANAPALLI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23419 W PEARSON DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-9609
Mailing Address - Country:US
Mailing Address - Phone:630-730-9037
Mailing Address - Fax:
Practice Address - Street 1:2484 US HIGHWAY 30 # B101
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-8974
Practice Address - Country:US
Practice Address - Phone:630-801-1999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL190363371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice