Individual provider Active NPI

Priyanka Nairi

  • Dentist
  • Chicago, IL
National Provider Identifier
1104337666
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019031416 Issued in IL
Practice address
676 N Michigan Ave Ste 3500
Chicago, IL 60611-2839
Phone
(312) 274-3333
NPI assigned
Oct 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019031416 IL Primary

Addresses

Primary practice location

676 N Michigan Ave Ste 3500
Chicago, IL 60611-2839

Mailing address

676 N Michigan Ave Ste 3500
Chicago, IL 60611-2839
Phone (312) 274-3333

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
I20180409000122 IL Order and Referring Only - DentistPractitioner - Dentist 3971866740

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019031416ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1104337666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 N MICHIGAN AVE STE 3500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112839",
            "telephone_number": "312-274-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N MICHIGAN AVE STE 3500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112839",
            "telephone_number": "312-274-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIRI",
        "first_name": "PRIYANKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-23",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019031416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.