Active NPI
Rana Ghazan Shahi, D.D.S., MS
- Dentist
- Maywood, IL
National Provider Identifier
1013209444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019.028662
- Practice address
- 2160 S 1St Ave
Maywood, IL 60153-3328 - Phone
- (708) 327-3041
- NPI assigned
- May 3, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.028662 | IL | Primary |
Addresses
Primary practice location
2160 S 1St Ave
Maywood, IL 60153-3328
Mailing address
1111 S. Wabash Ave
#2108
Chicago, IL 60605-2350
Phone (310) 925-0791
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jun 18, 2018 through Jun 18, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65211 | CA | MD | Clinical Social Worker |
| 019.028662 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339632000000",
"number": "1013209444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 S. WABASH AVE",
"address_2": "#2108",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606052350",
"telephone_number": "310-925-0791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2160 S 1ST AVE",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601533328",
"telephone_number": "708-327-3041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAHI",
"first_name": "RANA",
"middle_name": "GHAZAN",
"credential": "D.D.S., MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-03",
"last_updated": "2012-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.028662",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maywood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.