Active NPI
Sandy Ellen Kauffman, DDS
- Dentist
- Homewood, IL
National Provider Identifier
1255439550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- Practice address
- 18154 Harwood Ave
Ste 105
Homewood, IL 60430-2128 - Phone
- (708) 798-6888
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- 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
18154 Harwood Ave
Ste 105
Homewood, IL 60430-2128
Mailing address
18154 Harwood Ave
Ste 105
Homewood, IL 60430-2128
Phone (708) 798-6888
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160224000865 | IL | Order and Referring Only - Oral Surgery | 4284939547 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255439550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18154 HARWOOD AVE",
"address_2": "STE 105",
"city": "HOMEWOOD",
"state": "IL",
"postal_code": "604302128",
"telephone_number": "708-798-6888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18154 HARWOOD AVE",
"address_2": "STE 105",
"city": "HOMEWOOD",
"state": "IL",
"postal_code": "604302128",
"telephone_number": "708-798-6888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAUFFMAN",
"first_name": "SANDY",
"middle_name": "ELLEN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Homewood, IL
Sources for this page
- 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.