Individual provider Active NPI

Sumedha Mohindra, DDS

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1295085215
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019029269 Issued in IL
Practice address
901 S Ashland Ave
# 811 A
Chicago, IL 60607-4001
Phone
(630) 656-7513
NPI assigned
Sep 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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 019029269 IL Primary

Addresses

Primary practice location

901 S Ashland Ave
# 811 A
Chicago, IL 60607-4001

Mailing address

901 S Ashland Ave
# 811 A
Chicago, IL 60607-4001
Phone (630) 656-7513

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
019029269ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Swan Dental P.C. Past Accepting new patients
JNM Dental PC Past Accepting new patients

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": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1295085215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 S ASHLAND AVE",
            "address_2": "# 811 A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074001",
            "telephone_number": "630-656-7513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S ASHLAND AVE",
            "address_2": "# 811 A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074001",
            "telephone_number": "630-656-7513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHINDRA",
        "first_name": "SUMEDHA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-18",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019029269",
            "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 Mar 3, 2016; 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.