Individual provider Active NPI

Yasmeen Sultana, DMD

  • Dentist
  • Aurora, IL
National Provider Identifier
1194185348
Registry record updated Mar 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.030541 Issued in IL
Practice address
1264 N Lake St
Aurora, IL 60506-2453
Phone
(630) 801-9028
NPI assigned
Mar 1, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.030541 IL Primary

Addresses

Primary practice location

1264 N Lake St
Aurora, IL 60506-2453

Mailing address

330 Cedar LN
Apt 207
Glen Ellyn, IL 60137-6652
Phone (331) 425-0234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20170317000504 KS Order and Referring Only - DentistPractitioner - Dentist 5395020184

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.030541ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Whiteside Past Accepting new patients
County of Whiteside Dentist Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: yasmeen.sultana.p16@direct.fhn-fqhc.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1456790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456790400000",
    "number": "1194185348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 CEDAR LN",
            "address_2": "APT 207",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601376652",
            "telephone_number": "331-425-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1264 N LAKE ST",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605062453",
            "telephone_number": "630-801-9028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULTANA",
        "first_name": "YASMEEN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-01",
        "last_updated": "2016-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.030541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.