Active NPI
Susan Katherine Blair, D.D.S.
- Pediatric Dentistry
- Arlington Heights, IL
National Provider Identifier
1013204387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 021.002742
- Practice address
- 201 N Arlington Heights Rd
Arlington Heights, IL 60004-6059 - Phone
- (847) 670-9020
- NPI assigned
- Jul 6, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 021.002753 | IL | |
| Pediatric Dentistry | 1223P0221X | 021.002742 | IL | Primary |
Addresses
Primary practice location
201 N Arlington Heights Rd
Arlington Heights, IL 60004-6059
Mailing address
201 N Arlington Heights Rd
Arlington Heights, IL 60004-6059
Phone (847) 670-9020
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
| License | State | Type | Specialty |
|---|---|---|---|
| 021.002742 | IL | MD | Pediatric Dentist |
| 021.002753 | IL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513555200000",
"number": "1013204387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 N ARLINGTON HEIGHTS RD",
"city": "ARLINGTON HEIGHTS",
"state": "IL",
"postal_code": "600046059",
"telephone_number": "847-670-9020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 N ARLINGTON HEIGHTS RD",
"city": "ARLINGTON HEIGHTS",
"state": "IL",
"postal_code": "600046059",
"telephone_number": "847-670-9020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAIR",
"first_name": "SUSAN",
"middle_name": "KATHERINE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-06",
"last_updated": "2017-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "IL",
"license": "021.002753",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "IL",
"license": "021.002742",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arlington Heights, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.