Individual provider Active NPI

Stephen Sum, DDS

  • General Practice Dentistry
  • Burr Ridge, IL
National Provider Identifier
1326061763
Registry record updated Dec 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019018240 Issued in IL
Practice address
318 Burr Ridge Pkwy
Burr Ridge, IL 60527-6485
Phone
(630) 789-2292
Fax
(630) 789-2520
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2014

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 019018240 IL Primary

Addresses

Primary practice location

318 Burr Ridge Pkwy
Burr Ridge, IL 60527-6485

Mailing address

318 Burr Ridge Pkwy
Burr Ridge, IL 60527-6485
Phone (630) 789-2292

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
019018240ILMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418601600000",
    "number": "1326061763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 BURR RIDGE PKWY",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276485",
            "telephone_number": "630-789-2292",
            "fax_number": "630-789-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 BURR RIDGE PKWY",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276485",
            "telephone_number": "630-789-2292",
            "fax_number": "630-789-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUM",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2014-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019018240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burr Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; 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.