Individual provider Active NPI

Mladen Kralj, DMD

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1649340209
Registry record updated Dec 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19022824 Issued in IL
Practice address
937 W. Randolph
Chicago, IL 60607-5372
Phone
(312) 491-9494
Fax
(312) 491-9474
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 19022824 IL Primary
General Practice Dentistry 1223G0001X 19024641 IL

Addresses

Primary practice location

937 W. Randolph
Chicago, IL 60607-5372

Mailing address

937 W Randolph St
Chicago, IL 60607-2229
Phone (312) 491-9494

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
19022824ILMDGeneral Practice Dentistry
19024641ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ora Dental Studio West Loop LLC General Practice Past Accepting new patients
Studio of Aesthetic Dentistry 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230508800000",
    "number": "1649340209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "937 W RANDOLPH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072229",
            "telephone_number": "312-491-9494",
            "fax_number": "312-491-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "937 W. RANDOLPH",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606075372",
            "telephone_number": "312-491-9494",
            "fax_number": "312-491-9474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRALJ",
        "first_name": "MLADEN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2008-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19022824",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19024641",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Dec 29, 2008; 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.