Active NPI
Simona Bareket, DDS
- Dentist
- Chicago, IL
National Provider Identifier
1306036611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019.027316
- Practice address
- 1229 N Ashland Ave
Chicago, IL 60622-2204 - Phone
- (773) 252-5772
- NPI assigned
- Aug 1, 2007
- Last updated
- Aug 1, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.027316 | IL | Primary |
Addresses
Primary practice location
1229 N Ashland Ave
Chicago, IL 60622-2204
Mailing address
1647 Johnson Dr
Apt 431
Buffalo Grove, IL 60089-1868
Phone (847) 571-0167
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019.027316 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ogando DDS LLC | Past | Accepting new patients | |
| West Town Dental Group | Dentist | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Dentist
- Chicago, IL
- NPI 1245671676
-
- Dentist
- Chicago, IL
- NPI 1326038738
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185926400000",
"number": "1306036611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1647 JOHNSON DR",
"address_2": "APT 431",
"city": "BUFFALO GROVE",
"state": "IL",
"postal_code": "600891868",
"telephone_number": "847-571-0167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1229 N ASHLAND AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606222204",
"telephone_number": "773-252-5772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAREKET",
"first_name": "SIMONA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-01",
"last_updated": "2007-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.027316",
"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 Aug 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.