Individual provider Active NPI

Stella Nasiopoulos, D.M.D.

  • Dentist
  • Norridge, IL
National Provider Identifier
1356696447
Registry record updated Jul 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
052484-1 Issued in NY
Practice address
4919 N Sunrise LN
Norridge, IL 60706-3237
Phone
(312) 953-8075
NPI assigned
Jul 16, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 052484-1 NY Primary
Dentist 122300000X 009557 CT

Addresses

Primary practice location

4919 N Sunrise LN
Norridge, IL 60706-3237

Mailing address

4919 N Sunrise LN
Norridge, IL 60706-3237
Phone (312) 953-8075

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
009557CTMDDentist
052484-1NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1356696447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4919 N SUNRISE LN",
            "city": "NORRIDGE",
            "state": "IL",
            "postal_code": "607063237",
            "telephone_number": "312-953-8075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4919 N SUNRISE LN",
            "city": "NORRIDGE",
            "state": "IL",
            "postal_code": "607063237",
            "telephone_number": "312-953-8075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASIOPOULOS",
        "first_name": "STELLA",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-16",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "052484-1",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "009557",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; 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.