Individual provider Active NPI

Jamil Olomi, DMD

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1194285742
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.032373 Issued in IL
Practice address
4307 N Central Ave
Chicago, IL 60634-1815
Phone
(773) 286-0300
Fax
(773) 286-0340
NPI assigned
Mar 20, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 019.032373 IL Primary

Addresses

Primary practice location

4307 N Central Ave
Chicago, IL 60634-1815

Mailing address

2630 N Washtenaw Ave Apt 2N
Chicago, IL 60647-1824
Phone (224) 565-7705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019.032373ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Olomi Dental, P.C. General Practice CurrentSince Apr 6, 2025 Accepting new patients
Kushner Becker and Associates LTD PastSince Mar 1, 2024 Accepting new patients

Locations

4307 N Central Ave
Chicago, IL 60634
Phone (773) 283-3232

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": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1194285742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 N WASHTENAW AVE APT 2N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471824",
            "telephone_number": "224-565-7705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4307 N CENTRAL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606341815",
            "telephone_number": "773-286-0300",
            "fax_number": "773-286-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLOMI",
        "first_name": "JAMIL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.032373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2025; 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.