Individual provider Active NPI

Ardeshir Raghian, D.D.S., P.C.

  • Periodontics
  • Chicago, IL
National Provider Identifier
1265504617
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
021002028 Issued in IL
Practice address
5841 W Belmont Ave
Chicago, IL 60634-5201
Phone
(773) 622-3454
Fax
(773) 622-0990
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019-024426 IL
Periodontics 1223P0300X 021002028 IL Primary

Addresses

Primary practice location

5841 W Belmont Ave
Chicago, IL 60634-5201

Mailing address

5841 W Belmont Ave
Chicago, IL 60634-5201

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

LicenseStateTypeSpecialty
019-024426ILMDGeneral Practice Dentistry
021002028ILMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Ardeshir Raghian DDS PC CurrentSince Apr 13, 2025 Accepting new patients
Kiss Dental PC General Practice CurrentSince Jan 19, 2025 Accepting new patients

Locations

5841 W Belmont Ave
Chicago, IL 60634
Phone (773) 622-3454

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1265504617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5841 W BELMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606345201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 W BELMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606345201",
            "telephone_number": "773-622-3454",
            "fax_number": "773-622-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGHIAN",
        "first_name": "ARDESHIR",
        "name_prefix": "Dr.",
        "credential": "D.D.S., P.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-024426",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "021002028",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 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.