Individual provider Active NPI

Robert J. Shiffman, D.D.S.

  • General Practice Dentistry
  • Buffalo Grove, IL
National Provider Identifier
1629240197
Registry record updated Mar 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
195 N Arlington Heights Rd
Ste. 160
Buffalo Grove, IL 60089-8211
Phone
(847) 215-1511
Fax
(847) 243-0509
NPI assigned
Mar 25, 2008
Last updated
Mar 25, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X IL Primary

Addresses

Primary practice location

195 N Arlington Heights Rd
Ste. 160
Buffalo Grove, IL 60089-8211

Mailing address

195 N Arlington Heights Rd
Ste. 160
Buffalo Grove, IL 60089-8211
Phone (847) 215-1511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective May 24, 2016 through May 24, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019017271ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Shiffman Morris Dental Assoc. General Practice Past Accepting new patients

Organizations & group practices 1

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": "1206403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206403200000",
    "number": "1629240197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 N ARLINGTON HEIGHTS RD",
            "address_2": "STE. 160",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600898211",
            "telephone_number": "847-215-1511",
            "fax_number": "847-243-0509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 N ARLINGTON HEIGHTS RD",
            "address_2": "STE. 160",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600898211",
            "telephone_number": "847-215-1511",
            "fax_number": "847-243-0509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIFFMAN",
        "first_name": "ROBERT",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-25",
        "last_updated": "2008-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo Grove, IL

Sources for this page

Verify at the official NPI Registry.