Individual provider Active NPI

Badia Zahdan, DDS

  • General Practice Dentistry
  • Orland Park, IL
National Provider Identifier
1437683117
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
319.020577 Issued in IL
Practice address
15894 S la Grange Rd
Orland Park, IL 60467-5563
Phone
(708) 737-5325
NPI assigned
Apr 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 319.020577 IL Primary

Addresses

Primary practice location

15894 S la Grange Rd
Orland Park, IL 60467-5563

Mailing address

15894 S la Grange Rd
Orland Park, IL 60467-5563
Phone (708) 374-0118

Other practice location 1

10017 Menard Ave
Oak Lawn, IL 60453-3753
Phone (708) 374-0118

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
I20170815004594 IL Order and Referring Only - DentistPractitioner - Dentist 3476825100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
319.020577ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1437683117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15894 S LA GRANGE RD",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675563",
            "telephone_number": "708-374-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15894 S LA GRANGE RD",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675563",
            "telephone_number": "708-737-5325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10017 Menard Ave",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604533753",
            "country_code": "US",
            "telephone_number": "708-374-0118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAHDAN",
        "first_name": "BADIA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "319.020577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.