Active NPI
Deborah Frogameni, DDS
- General Practice Dentistry
- Chicago, IL
National Provider Identifier
1629007976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019-021744
- Practice address
- 5215 N California Ave
Chicago, IL 60625-7014 - Phone
- (312) 666-3494
- Fax
- (312) 666-6228
- NPI assigned
- Jun 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 30-018017 | OH | |
| General Practice Dentistry | 1223G0001X | 019-021744 | IL | Primary |
Addresses
Primary practice location
5215 N California Ave
Chicago, IL 60625-7014
Mailing address
1701 W Superior St
Chicago, IL 60622-5646
Phone (312) 666-3494
Other practice location 1
635 N Erie St
Attn Billing Office Mngr
Toledo, OH 43604
Phone (419) 213-4049
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019021744 | Medicaid | IL | |
| 2219281 | Medicaid | OH | |
| 600972 | Other | OH | BUCKEYE GROUP ID |
| 10246 | Other | OH | GROUP PARAMOUNT ID |
| 8822331 | Medicaid | OH | |
| 109100 | Other | OH | DORAL DENTAL |
| 88333OH | Other | OH | DELTA DENTAL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019-021744 | IL | MD | General Practice Dentistry |
| 30-018017 | OH | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542758400000",
"number": "1629007976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 W SUPERIOR ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606225646",
"telephone_number": "312-666-3494",
"fax_number": "312-666-6228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5215 N CALIFORNIA AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606257014",
"telephone_number": "312-666-3494",
"fax_number": "312-666-6228"
}
],
"practiceLocations": [
{
"address_1": "635 N Erie St",
"address_2": "Attn Billing Office Mngr",
"address_purpose": "LOCATION",
"city": "Toledo",
"state": "OH",
"postal_code": "43604",
"country_code": "US",
"telephone_number": "419-213-4049",
"fax_number": "419-213-4017",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FROGAMENI",
"first_name": "DEBORAH",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-30",
"last_updated": "2018-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "30-018017",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019-021744",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "019021744",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2219281",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BUCKEYE GROUP ID",
"identifier": "600972",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP PARAMOUNT ID",
"identifier": "10246",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8822331",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DORAL DENTAL",
"identifier": "109100",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL",
"identifier": "88333OH",
"state": "OH"
}
],
"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 Nov 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.