Steven Jordan Bacalar, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

019.029954 Issued in IL

Practice address

411 Linden Ave
Wilmette, IL 60091-2844

Phone

(847) 446-5868

NPI assigned

Sep 12, 2014

Last updated

May 26, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• George D Di Tola DDS LTD

  • Dentist
  • Melrose Park, IL
  • NPI 1598746364
  NPD (past)

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

{
    "created_epoch": "1410480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1649671389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 LINDEN AVE",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912844",
            "telephone_number": "847-446-5868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 LINDEN AVE",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912844",
            "telephone_number": "847-446-5868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3521 W Lake St",
            "address_purpose": "LOCATION",
            "city": "Melrose Park",
            "state": "IL",
            "postal_code": "601602825",
            "country_code": "US",
            "telephone_number": "708-865-1214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACALAR",
        "first_name": "STEVEN",
        "middle_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-12",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.029954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathy Apostal, DPM
• Irene Asaad
• At Home Medical Practitioners LLC
• Avoca School District 37
• Azam Abbasi (Dua Medicar)
• Thomas Alan Bailey, RPH
• Ann Petrus Baker, BSN, MPH, WHE
• Balance Centers of Illinois, LLC
• Devraj Banerjee, SA-C
• Nicholas Barin

• Dentist in Wilmette, IL
• Providers in Wilmette, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; 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.