Kajol Kansara, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019.032962 Issued in IL

Practice address

1639 S Cicero Ave
Cicero, IL 60804-1520

Phone

(708) 477-6717

NPI assigned

Jan 6, 2021

Sex

Female

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kajol.kansara.p11@direct.fhn-fqhc.nextgenshare.com

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.

• Promise Healthcare NFP

  • Federally Qualified Health Center (FQHC)
  • Champaign, IL
  • NPI 1578821005
  Medicare reassignment NPD
• Promise Healthcare NFP

  • Federally Qualified Health Center (FQHC)
  • Champaign, IL
  • NPI 1801687728
  NPD
• Promise Healthcare NFP

  • Federally Qualified Health Center (FQHC)
  • Urbana, IL
  • NPI 1952894180
  NPD
• Arif Samee, DDS CHTD

  • General Practice Dentistry
  • Cicero, IL
  • NPI 1558633958
  NPD (past)
• Cicero Dental Center LLC

  • General Practice Dentistry
  • Cicero, IL
  • NPI 1447767546
  NPD (past)

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1619565405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "671 HEATHER LN",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601035801",
            "telephone_number": "248-943-8127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1639 S CICERO AVE",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608041520",
            "telephone_number": "708-477-6717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANSARA",
        "first_name": "KAJOL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-06",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.032962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aisha Joyner
• Zalika Atiya Joyner
• JRD-RX, LLC
• Louise Marie Judge
• Carolyn P Kammer, BA
• Liam Michael Kennedy
• Saif Khan, DDS
• Kid Care Doctors
• Sumin Kim
• Unsoo Kim, DPT

• Dentist in Cicero, IL
• Providers in Cicero, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.