Active NPI
Ryan Nemeh
- General Practice Dentistry
- North Riverside, IL
National Provider Identifier
1538906128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019.035388
- Practice address
- 7345 W 25TH St
North Riverside, IL 60546-1409 - Phone
- (708) 447-0900
- NPI assigned
- Jul 10, 2024
- Last updated
- Jul 29, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019.035388 | IL | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
7345 W 25TH St
North Riverside, IL 60546-1409
Mailing address
8082 Garfield Ave Apt 6-3
Burr Ridge, IL 60527-7911
Phone (708) 966-6716
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019.035388 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Dental Clinc, LLC | General Practice | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- North Riverside, IL
- NPI 1811168800
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722211200000",
"number": "1538906128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8082 GARFIELD AVE APT 6-3",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605277911",
"telephone_number": "708-966-6716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7345 W 25TH ST",
"city": "NORTH RIVERSIDE",
"state": "IL",
"postal_code": "605461409",
"telephone_number": "708-447-0900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEMEH",
"first_name": "RYAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-07-10",
"last_updated": "2024-07-29",
"certification_date": "2024-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019.035388",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Riverside, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.