Individual provider Active NPI

Manika Agarwal, DMD, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Elmhurst, IL
National Provider Identifier
1053824987
Registry record updated Nov 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
021002810 Issued in IL
Practice address
275 N York St Ste 200
Elmhurst, IL 60126-2780
Phone
(630) 832-8320
NPI assigned
Nov 14, 2017
Last updated
Nov 21, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 021002810 IL Primary

Addresses

Primary practice location

275 N York St Ste 200
Elmhurst, IL 60126-2780

Mailing address

520 N Kingsbury St Unit 4603
Chicago, IL 60654-8616
Phone (201) 602-9150

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
021002810ILMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Orthodontic Specialists Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511222400000",
    "number": "1053824987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N KINGSBURY ST UNIT 4603",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606548616",
            "telephone_number": "201-602-9150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 N YORK ST STE 200",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262780",
            "telephone_number": "630-832-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGARWAL",
        "first_name": "MANIKA",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-14",
        "last_updated": "2017-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "021002810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.

Verify at the official NPI Registry.