NPIMap

Individual provider Active NPI

Gursimran Reen, DMD

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1528589090
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019031395 Issued in IL
Practice address
3057 W Cermak Rd
Chicago, IL 60623-3548
Phone
(773) 257-0200
NPI assigned
Jul 5, 2017
Last updated
Sep 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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 12012782A IN
General Practice Dentistry 1223G0001X 019031395 IL Primary

Addresses

Primary practice location

3057 W Cermak Rd
Chicago, IL 60623-3548

Mailing address

4133 Main St
Downers Grove, IL 60515-2141
Phone (330) 423-3528

Other practice location 1

4512 Parnell Ave
Fort Wayne, IN 46825
Phone (260) 399-1333

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
019031395ILMDGeneral Practice Dentistry
12012782AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Gursimran Reen, DMD LLC General Practice Current Accepting new patients
Gursimran Manaise, PLLC Current Accepting new patients
Dental Experts, LLC General Practice PastSince Oct 4, 2020 Accepting new patients

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": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1528589090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4133 MAIN ST",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152141",
            "telephone_number": "330-423-3528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3057 W CERMAK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606233548",
            "telephone_number": "773-257-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4512 Parnell Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "46825",
            "country_code": "US",
            "telephone_number": "260-399-1333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REEN",
        "first_name": "GURSIMRAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-05",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12012782A",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019031395",
            "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 Sep 28, 2020; 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.