Active NPI
Tanvi Mehta
- Dentist
- Palos Heights, IL
National Provider Identifier
1447769435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019031321
- Practice address
- 13303 S Ridgeland Ave Unit a
Palos Heights, IL 60463-0020 - Phone
- (708) 371-8400
- NPI assigned
- Sep 22, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | 019031321 | IL | Primary |
Addresses
Primary practice location
13303 S Ridgeland Ave Unit a
Palos Heights, IL 60463-0020
Mailing address
13303 S Ridgeland Ave Unit a
Palos Heights, IL 60463-0020
Phone (773) 286-1500
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 |
|---|---|---|---|
| 019031321 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506038400000",
"number": "1447769435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13303 S RIDGELAND AVE UNIT A",
"city": "PALOS HEIGHTS",
"state": "IL",
"postal_code": "604630020",
"telephone_number": "773-286-1500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13303 S RIDGELAND AVE UNIT A",
"city": "PALOS HEIGHTS",
"state": "IL",
"postal_code": "604630020",
"telephone_number": "708-371-8400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEHTA",
"first_name": "TANVI",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-09-22",
"last_updated": "2017-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019031321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palos Heights, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.