NPIMap

Individual provider Active NPI

Simona Bareket, DDS

  • Dentist
  • Chicago, IL
National Provider Identifier
1306036611
Registry record updated Aug 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.027316 Issued in IL
Practice address
1229 N Ashland Ave
Chicago, IL 60622-2204
Phone
(773) 252-5772
NPI assigned
Aug 1, 2007
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
019.027316ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ogando DDS LLC Past
since Jun 5, 2022		 Accepting new patients
West Town Dental Group Dentist Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.027316 IL Primary

Addresses

NPPES NPI Registry

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 1, 2007.

{
    "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.

Verify at the official NPI Registry.