Individual provider Active NPI

Richa Bhatia, DDS

  • Pediatric Dentistry
  • Oak Lawn, IL
National Provider Identifier
1003563529
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
019034704 Issued in IL
Practice address
6305 W 95TH St FL 2
Oak Lawn, IL 60453-2255
Phone
(708) 424-1300
Fax
(708) 424-1786
NPI assigned
Mar 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 019034704 IL Primary
Dentist 122300000X 2901601228 MI

Addresses

Primary practice location

6305 W 95TH St FL 2
Oak Lawn, IL 60453-2255

Mailing address

6305 W 95TH St FL 2
Oak Lawn, IL 60453-2255
Phone (708) 424-1300

Other practice location 1

410 Circle Ave
Forest Park, IL 60130-1734
Phone (708) 722-0017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2901601228MIMDDentist
019034704ILMDPediatric Dentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1003563529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6305 W 95TH ST FL 2",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532255",
            "telephone_number": "708-424-1300",
            "fax_number": "708-424-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6305 W 95TH ST FL 2",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532255",
            "telephone_number": "708-424-1300",
            "fax_number": "708-424-1786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 Circle Ave",
            "address_purpose": "LOCATION",
            "city": "Forest Park",
            "state": "IL",
            "postal_code": "601301734",
            "country_code": "US",
            "telephone_number": "708-722-0017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHATIA",
        "first_name": "RICHA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-04",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "019034704",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901601228",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.