Fnu Sameenabano

Primary specialty

DentistTaxonomy code 122300000X

License

019.033317 Issued in IL

Practice address

3435 W Irving Park Rd
Chicago, IL 60618-3217

Phone

(773) 588-8200

NPI assigned

Aug 6, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Irving Park Family Dentist

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1942595442
  NPD

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

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1700550290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 S ASHLAND AVE APT 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074094",
            "telephone_number": "630-440-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183217",
            "telephone_number": "773-588-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMEENABANO",
        "first_name": "FNU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-06",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019033317",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.033317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Datta Sambare, M.D.
• Tanmaya Datta Sambare, MD
• Anar Samedovi
• Emily Denise Samedy
• Mohammed Abdus Samee, M.D.
• Sameer P Shah LLC
• Mustafa Ali Samejo, MD
• Monica Kristin Samelson, MD
• Aviva Esther Samet, PSY.D
• Jonathan Samet, M.D.

• Dentist in Chicago, IL
• Providers in Chicago, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.