Active NPI
Tajulddin Kasar, DMD
- General Practice Dentistry
- North Utica, IL
National Provider Identifier
1669202891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019.035402
- Practice address
- 2937 Il-178
North Utica, IL 61373 - Phone
- (815) 993-3101
- NPI assigned
- Aug 2, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019.035402 | IL | Primary |
Addresses
Primary practice location
2937 Il-178
North Utica, IL 61373
Mailing address
840 Noren CT
Aurora, IL 60504-4864
Phone (630) 696-7322
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019.035402 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722556800000",
"number": "1669202891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "840 NOREN CT",
"city": "AURORA",
"state": "IL",
"postal_code": "605044864",
"telephone_number": "630-696-7322"
},
{
"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": "KASAR",
"first_name": "TAJULDDIN",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-08-02",
"last_updated": "2024-08-02",
"certification_date": "2024-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019.035402",
"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 Aug 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.