Individual provider Active NPI

Milona Van Kanegan, DDS

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1396945259
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019023957 Issued in IL
Practice address
2750 W North Ave
2ND Floor
Chicago, IL 60647-5247
Phone
(312) 432-4543
Fax
(773) 342-3204
NPI assigned
Jul 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019023957 IL Primary

Addresses

Primary practice location

2750 W North Ave
2ND Floor
Chicago, IL 60647-5247

Mailing address

2750 W North Ave
2ND Floor
Chicago, IL 60647-5247
Phone (312) 432-4543

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
I20160609002540 IL Order and Referring Only - DentistPractitioner - Dentist 0345530911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1396945259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 W NORTH AVE",
            "address_2": "2ND FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475247",
            "telephone_number": "312-432-4543",
            "fax_number": "773-342-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 W NORTH AVE",
            "address_2": "2ND FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475247",
            "telephone_number": "312-432-4543",
            "fax_number": "773-342-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN KANEGAN",
        "first_name": "MILONA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-19",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019023957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.