Individual provider Active NPI

Dimitri J. Haralampopoulos, DDS

  • Dentist
  • Chicago, IL
National Provider Identifier
1144221219
Registry record updated May 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019023680 Issued in IL
Practice address
2316 W Madison St
Chicago, IL 60612-2228
Phone
(312) 491-0601
NPI assigned
Aug 10, 2005
Last updated
May 15, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019023680 IL Primary

Addresses

Primary practice location

2316 W Madison St
Chicago, IL 60612-2228

Mailing address

PO Box 49
Glenview, IL 60025-0049

Other identifiers 1

IdentifierTypeStateIssuer
1002123MedicaidIL

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
I20160307000401 IL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 4880990563

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
HLM Dental PC Current Accepting new patients
Ash Dental PC Dentist Past Accepting new patients

Locations

2316 W Madison St
Chicago, IL 60612
Phone (312) 491-0601

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431648000000",
    "number": "1144221219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 49",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600250049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2316 W MADISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122228",
            "telephone_number": "312-491-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARALAMPOPOULOS",
        "first_name": "DIMITRI",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2015-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019023680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002123",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.