Individual provider Active NPI

Tricia Ann Letrero Woriax, DDS

  • Dentist
  • Chicago, IL
National Provider Identifier
1285783951
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
4039 W North Ave
Chicago, IL 60639-5219
Phone
(773) 782-4800
NPI assigned
Jan 10, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
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
Dentist 122300000X IL Primary

Addresses

Primary practice location

4039 W North Ave
Chicago, IL 60639-5219

Mailing address

430 W Erie St Ste 500
Chicago, IL 60610-4032
Phone (920) 838-1649

Other identifiers 1

IdentifierTypeStateIssuer
9181068MedicaidIL

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
I20160822000921 IL Order and Referring Only - DentistPractitioner - Dentist 4587959168

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-026934ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Experts, LLC 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, 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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285783951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 W ERIE ST STE 500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606104032",
            "telephone_number": "920-838-1649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4039 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606395219",
            "telephone_number": "773-782-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETRERO WORIAX",
        "first_name": "TRICIA",
        "middle_name": "ANN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9181068",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.