Individual provider Active NPI

Margaux Marie Derosset, D.M.D

  • Dentist
  • Chicago, IL
National Provider Identifier
1568644201
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
939 W North Ave
Chicago, IL 60622-7138
Phone
(312) 642-3370
NPI assigned
Dec 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 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

939 W North Ave
Chicago, IL 60622-7138

Mailing address

939 W North Ave
Chicago, IL 60622-7138
Phone (312) 642-3370

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
019.026601ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sweet Tooth Doc LTD CurrentSince Mar 13, 2022 Accepting new patients

Locations

2454 N Ashland Ave
Chicago, IL 60614
Phone (773) 525-7725

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": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1568644201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606227138",
            "telephone_number": "312-642-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606227138",
            "telephone_number": "312-642-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSSET",
        "first_name": "MARGAUX",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-05",
        "last_updated": "2007-12-05",
        "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

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; 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.