Individual provider Active NPI

Nishu Sharma, D.D.S

  • Dentist
  • Hanover Park, IL
National Provider Identifier
1063709186
Registry record updated Jul 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019028703 Issued in IL
Practice address
719 Weymouth Cir
Hanover Park, IL 60133-2731
Phone
(630) 808-3487
NPI assigned
Jul 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019028703 IL Primary

Addresses

Primary practice location

719 Weymouth Cir
Hanover Park, IL 60133-2731

Mailing address

719 Weymouth Cir
Hanover Park, IL 60133-2731

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
019028703ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Spark Dental PC Current Accepting new patients
King Dental, PC Current Accepting new patients
Stearns Dental PC CurrentSince Jan 19, 2025 Accepting new patients

Locations

910 S Il Route 59
Bartlett, IL 60103
Phone (630) 297-7966

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1310256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310256000000",
    "number": "1063709186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 WEYMOUTH CIR",
            "city": "HANOVER PARK",
            "state": "IL",
            "postal_code": "601332731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 WEYMOUTH CIR",
            "city": "HANOVER PARK",
            "state": "IL",
            "postal_code": "601332731",
            "telephone_number": "630-808-3487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARMA",
        "first_name": "NISHU",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-10",
        "last_updated": "2011-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019028703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2011; 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.