Individual provider Active NPI

Apis Nikrodhanond, PHDH, RDH

  • Advanced Practice Dental Therapist
  • Joliet, IL
National Provider Identifier
1063137834
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice Dental TherapistTaxonomy code 125K00000X
License
020.013083 Issued in IL
Practice address
1106 Neal Ave
Joliet, IL 60433-2548
Phone
(815) 727-8670
NPI assigned
Oct 5, 2022
Last updated
Oct 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Dental Therapist 125K00000X 020.013083 IL Primary

Addresses

Primary practice location

1106 Neal Ave
Joliet, IL 60433-2548

Mailing address

745 W Exchange St
Crete, IL 60417-2002
Phone (708) 508-0227

Other names 1

  • Apischaya Nikrodhanond Former name

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

LicenseStateTypeSpecialty
020.013083ILMDAdvanced Practice Dental Therapist

Interoperability endpoints

  • Direct secure messaging: apis.nikrodhanond.p25@direct.willcounty.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1063137834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 W EXCHANGE ST",
            "city": "CRETE",
            "state": "IL",
            "postal_code": "604172002",
            "telephone_number": "708-508-0227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 NEAL AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604332548",
            "telephone_number": "815-727-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKRODHANOND",
        "first_name": "APIS",
        "credential": "PHDH, RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "125K00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Dental Therapist",
            "state": "IL",
            "license": "020.013083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "APISCHAYA",
            "last_name": "NIKRODHANOND",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; 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.