Individual provider Active NPI

Katarina Surjancev, DMD

  • General Practice Dentistry
  • Oak Forest, IL
National Provider Identifier
1508796665
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.037246 Issued in IL
Practice address
6154 159TH St
Oak Forest, IL 60452-2906
Phone
(708) 687-0100
NPI assigned
May 21, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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 019.037246 IL Primary

Addresses

Primary practice location

6154 159TH St
Oak Forest, IL 60452-2906

Mailing address

1783 W Windmill CT
Addison, IL 60101-1865
Phone (630) 457-7974

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

NPI Registry JSON

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

{
    "created_epoch": "1779321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1508796665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1783 W WINDMILL CT",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601011865",
            "telephone_number": "630-457-7974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6154 159TH ST",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604522906",
            "telephone_number": "708-687-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURJANCEV",
        "first_name": "KATARINA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-21",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.037246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.