Active NPI
Soniya Salil Vasanwala, DMD
- General Practice Dentistry
- Dyer, IN
National Provider Identifier
1235616780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019.031581
- Practice address
- 890 Richard Rd Ste B
Dyer, IN 46311-1780 - Phone
- (815) 735-4963
- NPI assigned
- Jul 26, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019.031581 | IL | Primary |
Addresses
Primary practice location
890 Richard Rd Ste B
Dyer, IN 46311-1780
Mailing address
3540 Toulouse
Bourbonnais, IL 60914-4558
Phone (815) 735-4963
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019.031581 | Other | IL | STATE OF ILLINOIS |
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 |
|---|---|---|---|
| 019.031581 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532563200000",
"number": "1235616780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3540 TOULOUSE",
"city": "BOURBONNAIS",
"state": "IL",
"postal_code": "609144558",
"telephone_number": "815-735-4963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "890 RICHARD RD STE B",
"city": "DYER",
"state": "IN",
"postal_code": "463111780",
"telephone_number": "815-735-4963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VASANWALA",
"first_name": "SONIYA",
"middle_name": "SALIL",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-26",
"last_updated": "2018-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019.031581",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF ILLINOIS",
"identifier": "019.031581",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dyer, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.