Rosa Bellido-Griffin, D.M.D.
Individual provider Active NPI Dentist · Chicago, IL
NPI 1649484353 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1649484353
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 019022398 (IL)
- Practice address
- 4446 N Western Ave Ste 1
Chicago, IL 60625-2175 - Phone
- (872) 208-5240
- Fax
- (872) 208-5051
- NPI assigned
- May 10, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190412001581 | IL | Practitioner - Dentist | 4183911522 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019022398 | IL | MD | Dentist |
| 3392 | NH | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beloved Community Family Wellness Center | Current |
Accepting new patients | |
| Aria Dental Care PC | Dentist | Current |
Accepting new patients |
| Beloved Community Family Wellness Center | Current |
Accepting new patients |
Locations
326 W 64th St
Ste 205
Chicago, IL 60621
Phone (773) 651-3629
901 S 2nd St
Ste 201
Springfield, IL 62704
Phone (312) 560-2917
8500 W 110th St
Ste 450
Overland Park, KS 66210
Phone (913) 362-1112
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3392 | NH | |
| Dentist | 122300000X | 019022398 | IL | Yes |
Addresses
Primary practice location
4446 N Western Ave Ste 1
Chicago, IL 60625-2175
Mailing address
4446 N Western Ave Ste 1
Chicago, IL 60625-2175
Phone (872) 208-5240
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30303708 | Medicaid | NH | |
| 1001185 | Medicaid | IL |
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.