Active NPI
Lawrence Edward Feldman, D.D.S.
- General Practice Dentistry
- Chicago, IL
National Provider Identifier
1023259751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 19A13735
- Practice address
- 5549 N Broadway St
Chicago, IL 60640-1432 - Phone
- (773) 769-0123
- Fax
- (773) 769-5990
- NPI assigned
- Mar 9, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 19A13735 | IL | Primary |
Addresses
Primary practice location
5549 N Broadway St
Chicago, IL 60640-1432
Mailing address
5549 N Broadway St
Chicago, IL 60640-1432
Phone (773) 769-0123
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 |
|---|---|---|---|
| 19A13735 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236556800000",
"number": "1023259751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5549 N BROADWAY ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606401432",
"telephone_number": "773-769-0123",
"fax_number": "773-769-5990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5549 N BROADWAY ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606401432",
"telephone_number": "773-769-0123",
"fax_number": "773-769-5990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FELDMAN",
"first_name": "LAWRENCE",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-03-09",
"last_updated": "2009-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "19A13735",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.