Active NPI
Melissa Daza Mondero, DDS
- General Practice Dentistry
- Chicago, IL
National Provider Identifier
1356467328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019024160
- Practice address
- 1108 N Wells St
Chicago, IL 60610-2525 - Phone
- (312) 500-7080
- NPI assigned
- Mar 22, 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019024160 | IL | Primary |
Addresses
Primary practice location
1108 N Wells St
Chicago, IL 60610-2525
Mailing address
1937 W Wabansia Ave
Chicago, IL 60622-1343
Phone (312) 933-8304
Other practice location 1
5549 S Cornell Ave
Chicago, IL 60637-1914
Phone (773) 684-5702
Other names 1
- Dr. Melissa Daza
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 |
|---|---|---|---|
| 019024160 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smiles on North PC | Past | Accepting new patients | |
| Bucktown Wicker Park Dental | Past | Accepting new patients |
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.
-
- Dental Clinic/Center
- Chicago, IL
- NPI 1982049748
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783382400000",
"number": "1356467328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1937 W WABANSIA AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606221343",
"telephone_number": "312-933-8304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1108 N WELLS ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606102525",
"telephone_number": "312-500-7080"
}
],
"practiceLocations": [
{
"address_1": "5549 S Cornell Ave",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606371914",
"country_code": "US",
"telephone_number": "773-684-5702",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAZA MONDERO",
"first_name": "MELISSA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2026-07-07",
"certification_date": "2026-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019024160",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MELISSA",
"last_name": "DAZA",
"prefix": "DR.",
"credential": "DDS",
"code": "2",
"type": "Professional Name"
}
]
}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 Jul 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.