Active NPI
Dimitri Vasdekis, DDS
- Dentist
- Chicago, IL
National Provider Identifier
1376850891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019028421
- Practice address
- 3009 E 92ND St
Chicago, IL 60617-4502 - Phone
- (773) 978-1231
- Fax
- (773) 978-5136
- NPI assigned
- Sep 3, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 019028421 | IL | Primary |
Addresses
Primary practice location
3009 E 92ND St
Chicago, IL 60617-4502
Mailing address
3009 E 92ND St
Chicago, IL 60617-4502
Phone (773) 978-1231
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 |
|---|---|---|---|
| 019028421 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Dental Care | Dentist | Past | Accepting new patients |
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.
-
- Dentist
- Chicago, IL
- NPI 1578772299
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283472000000",
"number": "1376850891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3009 E 92ND ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606174502",
"telephone_number": "773-978-1231",
"fax_number": "773-978-5136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3009 E 92ND ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606174502",
"telephone_number": "773-978-1231",
"fax_number": "773-978-5136"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VASDEKIS",
"first_name": "DIMITRI",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-03",
"last_updated": "2010-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019028421",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.