Individual provider Active NPI

Muizz Merchant

  • General Practice Dentistry
  • Crystal Lake, IL
National Provider Identifier
1275010134
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.031801 Issued in IL
Practice address
720 Cog Cir Ste H
Crystal Lake, IL 60014-7301
Phone
(779) 220-4396
NPI assigned
Jul 24, 2018
Last updated
Jul 24, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019.031801 IL Primary

Addresses

Primary practice location

720 Cog Cir Ste H
Crystal Lake, IL 60014-7301

Mailing address

720 Cog Cir Ste H
Crystal Lake, IL 60014-7301
Phone (779) 220-4396

Other practice location 1

2429 Randall Rd Ste A
Carpentersville, IL 60110-3471
Phone (847) 844-0268

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
019.031801ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
BDD of Illinois P.C. General Practice Past Accepting new patients
BDD Alcd PC General Practice PastSince Nov 7, 2025 Accepting new patients
BDD Afds PC General Practice PastSince Nov 7, 2025 Accepting new patients

Organizations & group practices 3

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": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1275010134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 COG CIR STE H",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147301",
            "telephone_number": "779-220-4396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 COG CIR STE H",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147301",
            "telephone_number": "779-220-4396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2429 Randall Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Carpentersville",
            "state": "IL",
            "postal_code": "601103471",
            "country_code": "US",
            "telephone_number": "847-844-0268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERCHANT",
        "first_name": "MUIZZ",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-24",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.031801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.

Verify at the official NPI Registry.