Aziz Roman Susarrey, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.032169 Issued in IL

Practice address

7345 W 25TH St
North Riverside, IL 60546-1409

Phone

(708) 447-0900

NPI assigned

May 10, 2018

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 and National Provider Directory roles.

• Dental Dreams LLC

  • Dental Clinic/Center
  • Bourbonnais, IL
  • NPI 1083092670
  NPD (past)
• Premier Dental Clinc, LLC

  • General Practice Dentistry
  • North Riverside, IL
  • NPI 1811168800
  NPD (past)

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1669961173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N CLARK ST FL 6",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606544712",
            "telephone_number": "312-274-4524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7345 W 25TH ST",
            "city": "NORTH RIVERSIDE",
            "state": "IL",
            "postal_code": "605461409",
            "telephone_number": "708-447-0900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "567 W 14th St",
            "address_purpose": "LOCATION",
            "city": "Chicago Heights",
            "state": "IL",
            "postal_code": "604112323",
            "country_code": "US",
            "telephone_number": "283-708-9800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUSARREY",
        "first_name": "AZIZ",
        "middle_name": "ROMAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-10",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.032169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrice Smetana
• Isabel Ann Snyder, LCSW
• Melanie Elizabeth Solberg-Conner
• Solutions for Care
• Steven Spiro
• Tapiz Mental Health Services PLLC
• Ashley Temby, PT
• The Riverside Eye Corp
• Emily R Vanney, DDS
• Rayven Vaughn

• General Practice Dentistry in North Riverside, IL
• Providers in North Riverside, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.

Verify at the official NPI Registry.