Active NPI
Patrick King, D.D.S.
- General Practice Dentistry
- Cicero, IL
National Provider Identifier
1548424146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019026730
- Practice address
- 5539 W Cermak Rd
Cicero, IL 60804-2218 - Phone
- (708) 652-7575
- NPI assigned
- Jul 12, 2008
- Last updated
- Jul 12, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019026730 | IL | Primary |
Addresses
Primary practice location
5539 W Cermak Rd
Cicero, IL 60804-2218
Mailing address
801 S Paulina St RM 304D
Uic Cod Dept of Endo
Chicago, IL 60612-7210
Phone (630) 632-8269
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019026730 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Monil P Shah DMD PC | General Practice | Past | Accepting new patients |
| Dipak S Shah DDS LTD | Past | Accepting new patients |
Organizations & group practices 2
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
- Cicero, IL
- NPI 1568712123
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215820800000",
"number": "1548424146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 S PAULINA ST RM 304D",
"address_2": "UIC COD DEPT OF ENDO",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606127210",
"telephone_number": "630-632-8269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5539 W CERMAK RD",
"city": "CICERO",
"state": "IL",
"postal_code": "608042218",
"telephone_number": "708-652-7575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "PATRICK",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-12",
"last_updated": "2008-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019026730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cicero, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.