Rabia Asif Kassim, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

01903163 Issued in IL

Practice address

7310 N Villa Lake Dr Ste B
Peoria, IL 61614-8268

Phone

(309) 691-9072

NPI assigned

Jun 18, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Lifetime Dental Care of Illinois, PC

  • General Practice Dentistry
  • Peoria, IL
  • NPI 1487866919
  NPD (past)

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1134613813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7310 N VILLA LAKE DR STE B",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7310 N VILLA LAKE DR STE B",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148268",
            "telephone_number": "309-691-9072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSIM",
        "first_name": "RABIA",
        "middle_name": "ASIF",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "01903163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kailey Jean Karder, MSW
• Karen Gilmore Therapy and Coaching PLLC
• Irene P Kasambira, APN
• Ravindra Kashyap, M.D.
• Katherine Ann Kasper, M.D.
• Peggy Kastelein, IBCLC
• Kathy Karouzos Counseling, LLC
• Venkata Ramana Katikala, MBBS
• Vatsala Katiyar, MD
• Katrina Howard Nutrition

• Dentist in Peoria, IL
• Providers in Peoria, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; 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.