Individual provider Active NPI

Kamlesh G. Amin., DDS.

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1508803107
Registry record updated Oct 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019018874 Issued in IL
Practice address
3034 W Devon Ave
Ste 200
Chicago, IL 60659
Phone
(773) 262-5004
Fax
(773) 262-6752
NPI assigned
Jun 1, 2006
Last updated
Oct 21, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2015

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 019018874 IL Primary

Addresses

Primary practice location

3034 W Devon Ave
Ste 200
Chicago, IL 60659

Mailing address

3034 W Devon Ave
Ste 200
Chicago, IL 60659
Phone (773) 262-5004

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

LicenseStateTypeSpecialty
019018874ILMDGeneral Practice Dentistry

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445385600000",
    "number": "1508803107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3034 W DEVON AVE",
            "address_2": "STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60659",
            "telephone_number": "773-262-5004",
            "fax_number": "773-262-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3034 W DEVON AVE",
            "address_2": "STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60659",
            "telephone_number": "773-262-5004",
            "fax_number": "773-262-6752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIN.",
        "first_name": "KAMLESH",
        "middle_name": "G.",
        "name_prefix": "Mr.",
        "credential": "DDS.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2015-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019018874",
            "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 Oct 21, 2015; 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.