Edison A Ishaya, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

3855 W North Ave
Chicago, IL 60647-4640

Phone

(773) 782-8900

Fax

(773) 782-0577

NPI assigned

Mar 2, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Edison Ishaya Dental

  • General Practice Dentistry
  • Winnetka, CA
  • NPI 1578359832
  NPD Authorized official
• Family Dental Group, Inc.

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1538330758
  NPD (past)

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1124156773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3855 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474640",
            "telephone_number": "773-782-8900",
            "fax_number": "773-782-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474640",
            "telephone_number": "773-782-8900",
            "fax_number": "773-782-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISHAYA",
        "first_name": "EDISON",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103068",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002613",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Iseyemi
• Shahin Isha, MD
• Ayana A Isham, AGNP
• Sarah Ishamuddin
• Sandal Faisal Ishaque, MD
• Lauren Ann Isherwood, M.S.
• Hamza Ishfaq, M.D
• Talia Fatima Ishfaq
• Nora L Ishibashi, M.S.W., PH.D.
• David Ishikawa, PT, DPT

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.