Mazar Shuaipaj, DDS

Primary specialty

DentistTaxonomy code 122300000X

Practice address

4121 Fairview Ave
Ste 205
Downers Grove, IL 60515-2267

Phone

(630) 968-8439

Fax

(630) 968-7259

NPI assigned

Jan 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Smiles in Style LLC

  • Dental Clinic/Center
  • Palos Heights, IL
  • NPI 1518694322
  NPD Authorized official
• Edc of Downers Grove PLLC

  dba Dentique - Downers Grove

  • Dentist
  • Downers Grove, IL
  • NPI 1073282661
  NPD (past)
• Sparkle Dental Group LLC

  dba Dentique - Downers Grove

  • Dentist
  • Downers Grove, IL
  • NPI 1689404824
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205993193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 FAIRVIEW AVE",
            "address_2": "STE 205",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152267",
            "telephone_number": "630-968-8439",
            "fax_number": "630-968-7259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 FAIRVIEW AVE",
            "address_2": "STE 205",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152267",
            "telephone_number": "630-968-8439",
            "fax_number": "630-968-7259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUAIPAJ",
        "first_name": "MAZAR",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kee Dong Shin, M.D.
• Anjali Shirpurkar
• Lilit Shishikyan, PHARMD
• Eliza Shroba
• Nikita Shroff, PHARM D.
• Gregory Michael Shubat, DDS
• Jeffrey Shuert, PT
• Eric Shulman, M.D.
• Krista Marie Shutvet, MOT, OTR/L
• Billal Siddiq

• Dentist in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.