Organization Active NPI

Dental Heights DDS PC

  • Dentist
  • Glendale Heights, IL
National Provider Identifier
1063754232
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019028083 Issued in IL
Legal business name
DENTAL HEIGHTS DDS PC
Practice address
148 East Army Trail Road
Glendale Heights, IL 60139
Phone
(708) 369-6232
NPI assigned
Mar 26, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Authorized official

Name
Dr. Zishan Bader, DDSNPI 1164756979
Title
General Dentist
Phone
(708) 369-6232

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019028083 IL Primary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X

Addresses

Primary practice location

148 East Army Trail Road
Glendale Heights, IL 60139

Mailing address

148 East Army Trail Road
Glendale Heights, IL 60139
Phone (708) 369-6232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250502001688 IL DME Supplier - Oral Surgery - Dentist 9537686522 Practice locations: Glendale Heights, IL

National Provider Directory

National Provider Directory

Locations

148 E Army Trail Rd
Glendale Heights, IL 60139
Phone (224) 698-1472

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701907200000",
    "number": "1063754232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 EAST ARMY TRAIL ROAD",
            "city": "GLENDALE HEIGHTS",
            "state": "IL",
            "postal_code": "60139",
            "telephone_number": "708-369-6232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 EAST ARMY TRAIL ROAD",
            "city": "GLENDALE HEIGHTS",
            "state": "IL",
            "postal_code": "60139",
            "telephone_number": "708-369-6232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL HEIGHTS DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-26",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A",
        "authorized_official_last_name": "BADER",
        "authorized_official_first_name": "ZISHAN",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "708-369-6232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019028083",
            "primary": true
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.