Individual provider Active NPI

Babak Dokhanchi, DDS

  • General Practice Dentistry
  • Aurora, IL
National Provider Identifier
1093736761
Registry record updated Jan 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019-023025 Issued in IL
Practice address
2424 W Indian TRL Ste E
Aurora, IL 60506
Phone
(630) 896-1086
NPI assigned
Jul 21, 2006
Last updated
Jan 5, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 53501 CA
General Practice Dentistry 1223G0001X 019-023025 IL Primary

Addresses

Primary practice location

2424 W Indian TRL Ste E
Aurora, IL 60506

Mailing address

2424 W Indian TRL Ste E
Aurora, IL 60506-1588
Phone (630) 896-1086

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Oct 20, 2015 through Oct 20, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019-023025ILMDGeneral Practice Dentistry
53501CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dokhanchi Dental Services, DDS, PC Current Accepting new patients

Locations

2424 W Indian Trl
Ste E
Aurora, IL 60506
Phone (630) 896-1086

Organizations & group practices 1

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546646400000",
    "number": "1093736761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 W INDIAN TRL STE E",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605061588",
            "telephone_number": "630-896-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 W INDIAN TRL STE E",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "60506",
            "telephone_number": "630-896-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOKHANCHI",
        "first_name": "BABAK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2019-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53501",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-023025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.