Organization Active NPI

Mohammad R Ekhtera, DDS. PC

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1205084456
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
31901441 Issued in IL
Legal business name
MOHAMMAD R EKHTERA, DDS. PC
Practice address
3190 E. Elston Ave
Chicago, IL 60618-7129
Phone
(773) 564-9916
Fax
(872) 203-9984
NPI assigned
Aug 29, 2008
Last updated
Oct 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Authorized official

Name
Dr. Mohammad R Ekhtera, DDSNPI 1114908282
Title
President
Phone
(224) 875-0343

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 31901441 IL Primary

Addresses

Primary practice location

3190 E. Elston Ave
Chicago, IL 60618-7129

Mailing address

1700 Washington Ave
Wilmette, IL 60091-2421
Phone (224) 875-0343

Other identifiers 1

IdentifierTypeStateIssuer
1005436MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Mohammad R Ekhtera DDS PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4235 W Armitage Ave
Chicago, IL 60639
Phone (773) 342-1600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1219968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760918400000",
    "number": "1205084456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 WASHINGTON AVE",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912421",
            "telephone_number": "224-875-0343",
            "fax_number": "872-203-9984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3190 E. ELSTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606187129",
            "telephone_number": "773-564-9916",
            "fax_number": "872-203-9984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHAMMAD R EKHTERA, DDS. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-29",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A",
        "authorized_official_last_name": "EKHTERA",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "224-875-0343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "31901441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1005436",
            "state": "IL"
        }
    ],
    "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 Oct 20, 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.