Individual provider Active NPI

Atosa Sarrafi, DMD

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1104022235
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019026946 Issued in IL
Practice address
122 S Michigan Ave
Suite 1212
Chicago, IL 60603-6191
Phone
(312) 922-9595
NPI assigned
Jun 25, 2007
Sex
Female
Sole proprietor
Yes

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 019026946 IL Primary

Addresses

Primary practice location

122 S Michigan Ave
Suite 1212
Chicago, IL 60603-6191

Mailing address

260 E Chestnut St
Unit 3405
Chicago, IL 60611-2401
Phone (617) 388-4349

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
019026946ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Atosa Sarrafi,DMD,PC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104022235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 E CHESTNUT ST",
            "address_2": "UNIT 3405",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112401",
            "telephone_number": "617-388-4349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 S MICHIGAN AVE",
            "address_2": "SUITE 1212",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606036191",
            "telephone_number": "312-922-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARRAFI",
        "first_name": "ATOSA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019026946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.