Active NPI
Tarannum Marya
- Dentist
- Chicago, IL
National Provider Identifier
1497405161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019.033539
- Practice address
- 2101 E 71St St
Chicago, IL 60649-2143 - Phone
- (773) 241-7000
- NPI assigned
- Mar 25, 2022
- Sex
- Female
- Sole proprietor
- No
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 | 019.033539 | IL | Primary |
Addresses
Primary practice location
2101 E 71St St
Chicago, IL 60649-2143
Mailing address
3 Bayside Village PL Apt 402
San Francisco, CA 94107-1468
Phone (415) 827-5250
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 |
|---|---|---|---|
| 019.033539 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Artdentistree | Current | Accepting new patients |
Locations
6319 Fairview Ave
Ste 103
Westmont, IL 60559
Phone (630) 556-2062
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.
-
- Dental Clinic/Center
- Westmont, IL
- NPI 1780452706
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648166400000",
"number": "1497405161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 BAYSIDE VILLAGE PL APT 402",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941071468",
"telephone_number": "415-827-5250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 E 71ST ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606492143",
"telephone_number": "773-241-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARYA",
"first_name": "TARANNUM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-25",
"last_updated": "2022-03-25",
"certification_date": "2022-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.033539",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.