Individual provider Active NPI

Gary Treinkman, DDS

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1467575514
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019016514 Issued in IL
Practice address
901 N Ashland Ave
Chicago, IL 60622-5111
Phone
(773) 278-6622
Fax
(773) 252-1107
NPI assigned
Apr 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 019016514 IL Primary

Addresses

Primary practice location

901 N Ashland Ave
Chicago, IL 60622-5111

Mailing address

901 N Ashland Ave
Chicago, IL 60622-5111
Phone (773) 278-6622

Other identifiers 1

IdentifierTypeStateIssuer
200452797OtherILPIN NUMBER

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
I20150508001761 IL Order and Referring Only - DentistPractitioner - Dentist 3870812092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
019016514ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467575514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225111",
            "telephone_number": "773-278-6622",
            "fax_number": "773-252-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225111",
            "telephone_number": "773-278-6622",
            "fax_number": "773-252-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREINKMAN",
        "first_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019016514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN NUMBER",
            "identifier": "200452797",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.