Individual provider Active NPI

Nima Sanai, D.D.S.

  • Dentist
  • Chicago, IL
National Provider Identifier
1508855354
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
1514 W Devon Ave
Chicago, IL 60660-1314
Phone
(773) 761-2521
Fax
(773) 761-2522
NPI assigned
Oct 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X IL Primary

Addresses

Primary practice location

1514 W Devon Ave
Chicago, IL 60660-1314

Mailing address

1514 W Devon Ave
Chicago, IL 60660-1314
Phone (773) 761-2521

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
I20160401001551 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8820395072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Devon Dental Surgery, LTD. Dentist Past 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": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508855354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 W DEVON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606601314",
            "telephone_number": "773-761-2521",
            "fax_number": "773-761-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 W DEVON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606601314",
            "telephone_number": "773-761-2521",
            "fax_number": "773-761-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANAI",
        "first_name": "NIMA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.