Individual provider Active NPI

Christina Elizabeth Cardenas, DMD

  • Dentist
  • Chicago, IL
National Provider Identifier
1033733795
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.032567 Issued in IL
Practice address
2316 W Madison St Unit 2228
Chicago, IL 60612-2228
Phone
(312) 491-0601
NPI assigned
May 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.032567 IL Primary

Addresses

Primary practice location

2316 W Madison St Unit 2228
Chicago, IL 60612-2228

Mailing address

1340 N Astor St
Chicago, IL 60610-2171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20200720000814 IL Order and Referring Only - DentistPractitioner - Dentist 0547684995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.032567ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1590624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1033733795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 N ASTOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2316 W MADISON ST UNIT 2228",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122228",
            "telephone_number": "312-491-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDENAS",
        "first_name": "CHRISTINA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-28",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.032567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.