Individual provider Active NPI

Anisha Mohan Murarka, DDS

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1689955304
Registry record updated Jan 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.028851 Issued in IL
Practice address
4600 S Pulaski Rd
Chicago, IL 60632-4038
Phone
(773) 376-1111
NPI assigned
Sep 8, 2011
Last updated
Jan 29, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 27368 TX
General Practice Dentistry 1223G0001X 019.028851 IL Primary
General Practice Dentistry 1223G0001X 12012075A IN

Addresses

Primary practice location

4600 S Pulaski Rd
Chicago, IL 60632-4038

Mailing address

520 S State St Apt 1013
Chicago, IL 60605-1657
Phone (832) 265-6117

Other identifiers 3

IdentifierTypeStateIssuer
283698001MedicaidTX
283968003MedicaidTX
283968002MedicaidTX

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
019.028851ILMDGeneral Practice Dentistry
12012075AINMDGeneral Practice Dentistry
27368TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Chicago Dental Associates, Inc. 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1315440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390953600000",
    "number": "1689955304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S STATE ST APT 1013",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606051657",
            "telephone_number": "832-265-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 S PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606324038",
            "telephone_number": "773-376-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURARKA",
        "first_name": "ANISHA",
        "middle_name": "MOHAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-08",
        "last_updated": "2014-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27368",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.028851",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12012075A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "283698001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "283968003",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "283968002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; 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.