Sam B Bassali, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

407 W Prospect Ave
Mount Prospect, IL 60056-3059

Phone

(847) 394-4433

NPI assigned

Oct 6, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609963347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 W PROSPECT AVE",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600563059",
            "telephone_number": "847-394-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 W PROSPECT AVE",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600563059",
            "telephone_number": "847-394-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSALI",
        "first_name": "SAM",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine D Barczyk, PHARMD
• Barnes & Klatt PC
• Ann T Barnes, PSYD RD
• Hyim Joshua Baronofsky, DPM
• Lynn Leann Barrette, LCSW
• Valerie Beavers, LCSW
• George E Becker, L.C.S.W.
• Shehnaz Begum
• Ami Shah Behara, M.D.
• Venkata Y Behara, MD

• General Practice Dentistry in Mount Prospect, IL
• Providers in Mount Prospect, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.