Individual provider Active NPI

Jessie Zhu, DMD MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lake Forest, IL
National Provider Identifier
1366253916
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
019.035677 Issued in IL
Practice address
810 S Waukegan Rd Ste 101
Lake Forest, IL 60045-2672
Phone
(847) 615-5437
NPI assigned
Jan 14, 2025
Last updated
Jan 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 019.035677 IL Primary

Addresses

Primary practice location

810 S Waukegan Rd Ste 101
Lake Forest, IL 60045-2672

Mailing address

1850 Green Bay Rd # W303
Highland Park, IL 60035-3136
Phone (859) 433-5442

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
019.035677ILMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Forest Orthodontics and Pediatric Dentistry Orthodontics and Dentofacial Orthopedics CurrentSince Jan 19, 2025 Accepting new patients

Locations

810 S Waukegan Rd
Ste 101
Lake Forest, IL 60045
Phone (847) 615-5437

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1736812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1366253916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 GREEN BAY RD # W303",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353136",
            "telephone_number": "859-433-5442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 S WAUKEGAN RD STE 101",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600452672",
            "telephone_number": "847-615-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHU",
        "first_name": "JESSIE",
        "name_prefix": "Dr.",
        "credential": "DMD MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019.035677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; 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.