Active NPI
Afaq Mohammad Kheiri, DDS
- Dentist
- Chicago, IL
National Provider Identifier
1235276569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- Practice address
- 2316 W Madison St
Chicago, IL 60612-2228 - Phone
- (312) 491-0601
- Fax
- (312) 491-0602
- NPI assigned
- Jan 30, 2007
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | IL | Primary |
Addresses
Primary practice location
2316 W Madison St
Chicago, IL 60612-2228
Mailing address
1200 W Monroe St Apt 603
Chicago, IL 60607-2550
Phone (312) 243-0029
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9177289 | Medicaid | IL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019026552 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ash Dental PC | Dentist | Past | Accepting new patients |
Interoperability endpoints
- akheiri305693@direct.ochin.org
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1235276569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 W MONROE ST APT 603",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606072550",
"telephone_number": "312-243-0029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2316 W MADISON ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606122228",
"telephone_number": "312-491-0601",
"fax_number": "312-491-0602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHEIRI",
"first_name": "AFAQ",
"middle_name": "MOHAMMAD",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-30",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9177289",
"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 Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.