Individual provider Active NPI

Nathaniel Dancykier, D.D.S.

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1013383363
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019030259 Issued in IL
Practice address
801 S Paulina St
Chicago, IL 60612-7210
Phone
(312) 996-8925
NPI assigned
Aug 20, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019030259 IL Primary

Addresses

Primary practice location

801 S Paulina St
Chicago, IL 60612-7210

Mailing address

801 S Paulina St
Chicago, IL 60612-7210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191206000637 MD Order and Referring Only - DentistPractitioner - Dentist 1850724717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019030259ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1013383363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S PAULINA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S PAULINA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127210",
            "telephone_number": "312-996-8925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANCYKIER",
        "first_name": "NATHANIEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-20",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019030259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.