Budi Kusnoto, DDS, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

021002161 Issued in IL

Practice address

842 W 31St St
Chicago, IL 60608

Phone

(312) 804-8304

Fax

(312) 873-3803

NPI assigned

Oct 12, 2006

Last updated

Jan 28, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Allcare Orthodontic Center LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chicago, IL
  • NPI 1457775710
  NPD (past) Authorized official

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390867200000",
    "number": "1447349618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 W POLK ST",
            "address_2": "SUITE 251",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052000",
            "telephone_number": "312-804-8304",
            "fax_number": "312-873-3803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "842 W 31ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60608",
            "telephone_number": "312-804-8304",
            "fax_number": "312-873-3803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSNOTO",
        "first_name": "BUDI",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2014-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019022824",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "021002161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Kushner, MD
• Nana Afua Agyeman Kusi
• Rebecca Kusiak, BCBA
• Aliya Kusko, MD
• Boris Kusnetzow, M.D.
• Trevor R Kuston, M.D.
• Marissa Kusy-Leavitt
• Katarzyna Dorota Kusz, D.D.S.
• Eugene Kutasevich, PSYD
• Aaron Matthew Kutinsky, DDS

• Orthodontics and Dentofacial Orthopedics Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; 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.