Individual provider Active NPI

Akanksha Baheti

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1710762182
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.034561 Issued in IL
Practice address
4434 W Fullerton Ave
Chicago, IL 60639-1932
Phone
(229) 443-2124
NPI assigned
Aug 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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 019.034561 IL Primary

Addresses

Primary practice location

4434 W Fullerton Ave
Chicago, IL 60639-1932

Mailing address

215 W Washington St Apt 3203
Chicago, IL 60606-3516
Phone (229) 443-2124

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
019.034561ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1710762182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 W WASHINGTON ST APT 3203",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606063516",
            "telephone_number": "229-443-2124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4434 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391932",
            "telephone_number": "229-443-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHETI",
        "first_name": "AKANKSHA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-25",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.034561",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 25, 2023; 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.