Individual provider Active NPI

Lawrence Velano

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1487642823
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019-025654 Issued in IL
Practice address
5333 N Clark St
Chicago, IL 60640-2121
Phone
(773) 728-5333
Fax
(773) 728-7405
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

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 019-025654 IL Primary

Addresses

Primary practice location

5333 N Clark St
Chicago, IL 60640-2121

Mailing address

5333 N Clark St
Chicago, IL 60640-2121
Phone (773) 728-5333

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151207000438 IL Order and Referring Only - Other (Non-Physician) 3779883251

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Little Village Dental PC PastSince Jul 16, 2023 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1487642823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5333 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402121",
            "telephone_number": "773-728-5333",
            "fax_number": "773-728-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402121",
            "telephone_number": "773-728-5333",
            "fax_number": "773-728-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELANO",
        "first_name": "LAWRENCE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-025654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.