Individual provider Active NPI

Michael Vold, D.D.S.

  • General Practice Dentistry
  • Northbrook, IL
National Provider Identifier
1275649709
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
1535 Lake Cook Rd
Suite #602
Northbrook, IL 60062-1447
Phone
(847) 272-2900
Fax
(847) 272-3070
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

1535 Lake Cook Rd
Suite #602
Northbrook, IL 60062-1447

Mailing address

1535 Lake Cook Rd
Suite #602
Northbrook, IL 60062-1447
Phone (847) 272-2900

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160308001733 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6507162104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northbrook Court Dental Associates,P.C. General Practice Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275649709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 LAKE COOK RD",
            "address_2": "SUITE #602",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621447",
            "telephone_number": "847-272-2900",
            "fax_number": "847-272-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 LAKE COOK RD",
            "address_2": "SUITE #602",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621447",
            "telephone_number": "847-272-2900",
            "fax_number": "847-272-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOLD",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.