Individual provider Active NPI

Betti Shahin, DMD, DPDS, MSC

  • Dentist
  • Chicago, IL
National Provider Identifier
1447743836
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019031636 Issued in IL
Practice address
712 E 87TH St
Chicago, IL 60619-6246
Phone
(773) 783-9000
NPI assigned
Jun 11, 2018
Last updated
Jun 11, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019031636 IL Primary

Addresses

Primary practice location

712 E 87TH St
Chicago, IL 60619-6246

Mailing address

6933 N Kedzie Ave Apt 1016
Chicago, IL 60645-2728
Phone (773) 381-9637

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
I20180717001044 IL Order and Referring Only - DentistPractitioner - Dentist 8527315936

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019031636ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Smiling Dental International P.C. Dentist PastSince Apr 6, 2021 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, 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": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1447743836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6933 N KEDZIE AVE APT 1016",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606452728",
            "telephone_number": "773-381-9637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 E 87TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606196246",
            "telephone_number": "773-783-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHIN",
        "first_name": "BETTI",
        "name_prefix": "Dr.",
        "credential": "DMD, DPDS, MSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019031636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.