Individual provider Active NPI

Vlad Ferdkoff, D.D.S.

  • Dentist
  • Barrington, IL
National Provider Identifier
1689789596
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
1531 S Grove Ave # S.106
Barrington, IL 60010-5211
Phone
(847) 842-2410
Fax
(847) 842-0564
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X IL Primary

Addresses

Primary practice location

1531 S Grove Ave # S.106
Barrington, IL 60010-5211

Mailing address

1531 S Grove Ave # S.106
Barrington, IL 60010-5211
Phone (847) 842-2410

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
I20160120000023 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4486957834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-024754ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Barrington Prodental Care PC 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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689789596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 S GROVE AVE # S.106",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600105211",
            "telephone_number": "847-842-2410",
            "fax_number": "847-842-0564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1531 S GROVE AVE # S.106",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600105211",
            "telephone_number": "847-842-2410",
            "fax_number": "847-842-0564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERDKOFF",
        "first_name": "VLAD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barrington, IL

Sources for this page

Verify at the official NPI Registry.