Individual provider Active NPI

Sayed Haroon B Shah, DMD

  • General Practice Dentistry
  • Hoffman Estates, IL
National Provider Identifier
1093887366
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019-026152 Issued in IL
Practice address
1000 Grand Canyon Pkwy
209
Hoffman Estates, IL 60196-0001
Phone
(847) 310-9816
Fax
(847) 310-9817
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019-026152 IL Primary

Addresses

Primary practice location

1000 Grand Canyon Pkwy
209
Hoffman Estates, IL 60196-0001

Mailing address

1000 Grand Canyon Pkwy
209
Hoffman Estates, IL 60196-0001
Phone (847) 310-9816

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150602002944 IL Order and Referring Only - DentistPractitioner - Dentist 2769703768

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-026152ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
County of Whiteside General Practice Past Accepting new patients
County of Whiteside General Practice Past Accepting new patients
Access Health Care, Inc. PastSince Sep 1, 2015 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: haroon.shah.p16@direct.fhn-fqhc.nextgenshare.com

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093887366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 GRAND CANYON PKWY",
            "address_2": "209",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601960001",
            "telephone_number": "847-310-9816",
            "fax_number": "847-310-9817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 GRAND CANYON PKWY",
            "address_2": "209",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601960001",
            "telephone_number": "847-310-9816",
            "fax_number": "847-310-9817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SAYED HAROON",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-026152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoffman Estates, IL

Sources for this page

Verify at the official NPI Registry.