Individual provider Active NPI

Victoria A Ursitti, D.M.D

  • Pediatric Dentistry
  • Arlington Heights, IL
National Provider Identifier
1295953529
Registry record updated Apr 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
21001777 Issued in IL
Practice address
3030 W Salt Creek LN Ste 130
Arlington Heights, IL 60005-5006
Phone
(847) 870-0475
NPI assigned
Apr 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2022

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 19023620 IL
Pediatric Dentistry 1223P0221X 21001777 IL Primary

Addresses

Primary practice location

3030 W Salt Creek LN Ste 130
Arlington Heights, IL 60005-5006

Mailing address

3030 W Salt Creek LN Ste 130
Arlington Heights, IL 60005-5006
Phone (847) 870-0475

Other practice location 1

4097 W Algonquin Rd
Algonquin, IL 60102-9401
Phone (224) 654-6543

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
19023620ILMDGeneral Practice Dentistry
21001777ILMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
All About Kids Dentistry, LLC Pediatric Dentistry CurrentSince Aug 1, 2021 Accepting new patients
Algonquin Kids Dentistry, Inc Pediatric Dentistry Current Accepting new patients

Locations

4097 W Algonquin Rd
Algonquin, IL 60102
Phone (224) 654-6543

3030 W Salt Creek Ln
Ste 130
Arlington Heights, IL 60005
Phone (847) 870-0475

1845 E Rand Rd
Ste 203
Arlington Heights, IL 60004

411 W Walnut St
Ste 201
Mount Prospect, IL 60056

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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648857600000",
    "number": "1295953529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 W SALT CREEK LN STE 130",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600055006",
            "telephone_number": "847-870-0475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 W SALT CREEK LN STE 130",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600055006",
            "telephone_number": "847-870-0475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4097 W Algonquin Rd",
            "address_purpose": "LOCATION",
            "city": "Algonquin",
            "state": "IL",
            "postal_code": "601029401",
            "country_code": "US",
            "telephone_number": "224-654-6543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "URSITTI",
        "first_name": "VICTORIA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2022-04-02",
        "certification_date": "2022-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19023620",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "21001777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2022; 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.