Individual provider Active NPI

Ludmila Kolarikova, DMD

  • Dentist
  • Chicago, IL
National Provider Identifier
1477064467
Registry record updated Oct 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.031423 Issued in IL
Practice address
7064 W Belmont Ave
Chicago, IL 60634-4592
Phone
(773) 840-0340
NPI assigned
Oct 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.031423 IL Primary

Addresses

Primary practice location

7064 W Belmont Ave
Chicago, IL 60634-4592

Mailing address

6935 W Barry Ave
Chicago, IL 60634-4610

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
I20180619000744 IL Order and Referring Only - DentistPractitioner - Dentist 1456606292

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.031423ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508198400000",
    "number": "1477064467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6935 W BARRY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7064 W BELMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344592",
            "telephone_number": "773-840-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLARIKOVA",
        "first_name": "LUDMILA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-17",
        "last_updated": "2017-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.031423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.