Individual provider Active NPI

Mohammad Ismail Dogar, D.M.D

  • Dentist
  • Belvidere, IL
National Provider Identifier
1639610678
Registry record updated Jan 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019031883 Issued in IL
Practice address
916 Belvidere Rd
Belvidere, IL 61008-9360
Phone
(815) 544-3111
NPI assigned
Mar 9, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019031883 IL Primary

Addresses

Primary practice location

916 Belvidere Rd
Belvidere, IL 61008-9360

Mailing address

916 Belvidere Rd
Belvidere, IL 61008-9360
Phone (815) 544-3111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20170728001170 NM Order and Referring Only - DentistPractitioner - Dentist 9739459413

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019031883ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547424000000",
    "number": "1639610678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 BELVIDERE RD",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610089360",
            "telephone_number": "815-544-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 BELVIDERE RD",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610089360",
            "telephone_number": "815-544-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOGAR",
        "first_name": "MOHAMMAD",
        "middle_name": "ISMAIL",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-09",
        "last_updated": "2019-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019031883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belvidere, IL

Sources for this page

Verify at the official NPI Registry.