Individual provider Active NPI

Neha Ibne-Rasa, DMD

  • Dentist
  • Chicago, IL
National Provider Identifier
1346865805
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019032644 Issued in IL
Practice address
712 E 87TH St
Chicago, IL 60619-6246
Phone
(773) 783-9000
NPI assigned
Jun 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019032644 IL Primary

Addresses

Primary practice location

712 E 87TH St
Chicago, IL 60619-6246

Mailing address

903 S Ashland Ave Apt 315
Chicago, IL 60607-4096
Phone (917) 302-1124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200805003307 IL Order and Referring Only - DentistPractitioner - Dentist 5395160428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Smiling Dental International P.C. Dentist CurrentSince Apr 6, 2021 Accepting new patients

Locations

712 E 87th St
Chicago, IL 60619
Phone (773) 456-7071

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": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1346865805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 S ASHLAND AVE APT 315",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074096",
            "telephone_number": "917-302-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 E 87TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606196246",
            "telephone_number": "773-783-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBNE-RASA",
        "first_name": "NEHA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-10",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019032644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.