Individual provider Active NPI

Ayman Zaki, DMD

  • Dentist
  • Cicero, IL
National Provider Identifier
1619545019
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019033145 Issued in IL
Practice address
3020 S Cicero Ave
Cicero, IL 60804-3638
Phone
(708) 863-2000
NPI assigned
Jun 14, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019033145 IL Primary

Addresses

Primary practice location

3020 S Cicero Ave
Cicero, IL 60804-3638

Mailing address

1142 E Addison Ave
Lombard, IL 60148-6504
Phone (407) 844-3844

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
019033145ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Image Dental LLC PastSince Jun 22, 2021 Accepting new patients
Braces Town PC PastSince Jun 22, 2021 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1619545019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1142 E ADDISON AVE",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486504",
            "telephone_number": "407-844-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 S CICERO AVE",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608043638",
            "telephone_number": "708-863-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAKI",
        "first_name": "AYMAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019033145",
            "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 Jun 14, 2021; 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.