Individual provider Active NPI

Betty Papanicolaou, DDS

  • Dentist
  • Norridge, IL
National Provider Identifier
1689845976
Registry record updated Mar 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
4830 N Cumberland Ave
Ste #3
Norridge, IL 60706
Phone
(708) 456-0746
Fax
(708) 456-0775
NPI assigned
Mar 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2008

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

4830 N Cumberland Ave
Ste #3
Norridge, IL 60706

Mailing address

4830 N Cumberland Ave
Ste #3
Norridge, IL 60706
Phone (708) 456-0746

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
019022932ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205452800000",
    "number": "1689845976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4830 N CUMBERLAND AVE",
            "address_2": "STE #3",
            "city": "NORRIDGE",
            "state": "IL",
            "postal_code": "60706",
            "telephone_number": "708-456-0746",
            "fax_number": "708-456-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4830 N CUMBERLAND AVE",
            "address_2": "STE #3",
            "city": "NORRIDGE",
            "state": "IL",
            "postal_code": "60706",
            "telephone_number": "708-456-0746",
            "fax_number": "708-456-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPANICOLAOU",
        "first_name": "BETTY",
        "name_prefix": "Ms.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-14",
        "last_updated": "2008-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.