Individual provider Active NPI

Aditya Nilesh Pai

  • General Practice Dentistry
  • North Utica, IL
National Provider Identifier
1659048320
Registry record updated Sep 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.033371 Issued in IL
Practice address
2937 Il-178
North Utica, IL 61373
Phone
(815) 993-3101
NPI assigned
Aug 30, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2021

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 019.033371 IL Primary

Addresses

Primary practice location

2937 Il-178
North Utica, IL 61373

Mailing address

23806 Springs CT Apt 103
Plainfield, IL 60585-2262
Phone (510) 388-9343

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
019.033371ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630800000000",
    "number": "1659048320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23806 SPRINGS CT APT 103",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605852262",
            "telephone_number": "510-388-9343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2937 IL-178",
            "city": "NORTH UTICA",
            "state": "IL",
            "postal_code": "61373",
            "telephone_number": "815-993-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAI",
        "first_name": "ADITYA",
        "middle_name": "NILESH",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-30",
        "last_updated": "2021-09-05",
        "certification_date": "2021-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.033371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Utica, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2021; 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.