Individual provider Active NPI

Gaganpreet Kaur Bhattal, DMD

  • General Practice Dentistry
  • Skokie, IL
National Provider Identifier
1619499167
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
61384541 Issued in WA
Practice address
5225 Touhy Ave
Skokie, IL 60077-3245
Phone
(847) 807-7341
NPI assigned
Jul 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1001651-15 WI
General Practice Dentistry 1223G0001X 019.031262 IL
General Practice Dentistry 1223G0001X 61384541 WA Primary

Addresses

Primary practice location

5225 Touhy Ave
Skokie, IL 60077-3245

Mailing address

1 W Peter LN
Hawthorn Woods, IL 60047-7512
Phone (847) 845-4406

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

LicenseStateTypeSpecialty
019.031262ILMDGeneral Practice Dentistry
61384541WAMDGeneral Practice Dentistry
1001651-15WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mena Dental PLLC General Practice CurrentSince Apr 20, 2025 Accepting new patients
Mithila Sharma DDS PLLC General Practice CurrentSince Sep 24, 2023 Accepting new patients

Locations

5225 Touhy Ave
Skokie, IL 60077
Phone (847) 521-6676

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.

NPI Registry JSON

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

{
    "created_epoch": "1500076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1619499167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W PETER LN",
            "city": "HAWTHORN WOODS",
            "state": "IL",
            "postal_code": "600477512",
            "telephone_number": "847-845-4406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 TOUHY AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773245",
            "telephone_number": "847-807-7341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHATTAL",
        "first_name": "GAGANPREET",
        "middle_name": "KAUR",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-15",
        "last_updated": "2023-09-22",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1001651-15",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.031262",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "61384541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; 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.