Individual provider Active NPI

Shuchi Goyal

  • Dentist
  • Aurora, IL
National Provider Identifier
1326722364
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.034351 Issued in IL
Practice address
1195 Birchdale LN
Aurora, IL 60504-6550
Phone
(630) 839-9778
NPI assigned
Jun 12, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.034351 IL Primary

Addresses

Primary practice location

1195 Birchdale LN
Aurora, IL 60504-6550

Mailing address

1195 Birchdale LN
Aurora, IL 60504-6550
Phone (630) 839-9778

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
019.034351ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1326722364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1195 BIRCHDALE LN",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605046550",
            "telephone_number": "630-839-9778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1195 BIRCHDALE LN",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605046550",
            "telephone_number": "630-839-9778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOYAL",
        "first_name": "SHUCHI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.034351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.