Individual provider Active NPI

Sreelekha Sama, D.D.S

  • General Practice Dentistry
  • Addison, IL
National Provider Identifier
1528181575
Registry record updated Mar 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019026520 Issued in IL
Practice address
190 N Swift Rd
Addison, IL 60101-1476
Phone
(630) 627-7626
NPI assigned
Apr 6, 2007
Last updated
Mar 30, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019026520 IL Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 019.026520 IL

Addresses

Primary practice location

190 N Swift Rd
Addison, IL 60101-1476

Mailing address

190 N Swift Rd
Addison, IL 60101-1476
Phone (630) 627-7626

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
I20230125002081 IL Practitioner - Dentist 5294106423 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.026520ILMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Vna Health Care CurrentSince Sep 28, 2022 Accepting new patients
Vna Health Care CurrentSince Sep 28, 2022 Accepting new patients

Locations

400 N Highland Ave
Aurora, IL 60506

Interoperability endpoints

  • Direct secure messaging: ssama589605@direct.ochin.org

Organizations & group practices 3

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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459296000000",
    "number": "1528181575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 N SWIFT RD",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601011476",
            "telephone_number": "630-627-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 N SWIFT RD",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601011476",
            "telephone_number": "630-627-7626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMA",
        "first_name": "SREELEKHA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2016-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019026520",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019.026520",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, IL

Sources for this page

Verify at the official NPI Registry.