Individual provider Active NPI

Kaori Ema, DDS

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1679872832
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019028664 Issued in IL
Practice address
705 S Clark St
Chicago, IL 60605-1703
Phone
(312) 435-0411
NPI assigned
Mar 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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 019028664 IL Primary

Addresses

Primary practice location

705 S Clark St
Chicago, IL 60605-1703

Mailing address

705 S Clark St
Chicago, IL 60605-1703
Phone (312) 435-0411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150602002350 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9931420916

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019028664ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kaori C. Ema, DDS, P.C. General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1301097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1679872832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 S CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606051703",
            "telephone_number": "312-435-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 S CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606051703",
            "telephone_number": "312-435-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMA",
        "first_name": "KAORI",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-26",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019028664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.