Individual provider Active NPI

Marina Borochin, DDS

  • General Practice Dentistry
  • Niles, IL
National Provider Identifier
1649234683
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019-025194 Issued in IL
Practice address
9052 W Golf Rd
Niles, IL 60714-5805
Phone
(847) 297-4815
NPI assigned
Apr 14, 2006
Last updated
Sep 4, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2012

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 019-025194 IL Primary

Addresses

Primary practice location

9052 W Golf Rd
Niles, IL 60714-5805

Mailing address

9052 W Golf Rd
Niles, IL 60714-5805
Phone (847) 297-4815

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
019-025194ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Shaivalkumar Patel DDS P.C PastSince Nov 10, 2019 Accepting new patients
Dental Perfection General Practice Past 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, 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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1649234683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9052 W GOLF RD",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607145805",
            "telephone_number": "847-297-4815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9052 W GOLF RD",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607145805",
            "telephone_number": "847-297-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOROCHIN",
        "first_name": "MARINA",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-025194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; 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.