Individual provider Active NPI

Shikha Bubna, D.D.S.

  • Dentist
  • Palos Heights, IL
National Provider Identifier
1164622825
Registry record updated Jul 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19027469 Issued in IL
Practice address
12001 S Harlem Ave
Palos Heights, IL 60463-1139
Phone
(708) 448-6700
Fax
(708) 448-7939
NPI assigned
Jul 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 19027469 IL Primary

Addresses

Primary practice location

12001 S Harlem Ave
Palos Heights, IL 60463-1139

Mailing address

12001 S Harlem Ave
Palos Heights, IL 60463-1139
Phone (708) 448-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Nov 16, 2018 through Nov 16, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
19027469ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184889600000",
    "number": "1164622825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12001 S HARLEM AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631139",
            "telephone_number": "708-448-6700",
            "fax_number": "708-448-7939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12001 S HARLEM AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631139",
            "telephone_number": "708-448-6700",
            "fax_number": "708-448-7939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUBNA",
        "first_name": "SHIKHA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-20",
        "last_updated": "2007-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "19027469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.