Individual provider Active NPI

Darren Cyrus Pakravan, D.D.S., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chicago, IL
National Provider Identifier
1295995140
Registry record updated Feb 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
021002299 Issued in IL
Practice address
2921 N Lincoln Ave
Ground Floor
Chicago, IL 60657-8618
Phone
(773) 697-8038
NPI assigned
Jun 13, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019026387 IL
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 021002299 IL Primary

Addresses

Primary practice location

2921 N Lincoln Ave
Ground Floor
Chicago, IL 60657-8618

Mailing address

2921 N Lincoln Ave
Ground Floor
Chicago, IL 60657-8618

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
019026387ILMDDentist
021002299ILMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Windy City Orthodontics, LTD. Orthodontics and Dentofacial Orthopedics 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": "1213315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297382400000",
    "number": "1295995140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 N LINCOLN AVE",
            "address_2": "GROUND FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606578618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 N LINCOLN AVE",
            "address_2": "GROUND FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606578618",
            "telephone_number": "773-697-8038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAKRAVAN",
        "first_name": "DARREN",
        "middle_name": "CYRUS",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-13",
        "last_updated": "2011-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019026387",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "021002299",
            "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 Feb 11, 2011; 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.