Farai Kambasha, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019026906 Issued in IL

Practice address

1240 Essington Rd Ste 200
Joliet, IL 60435-8410

Phone

(815) 744-1212

NPI assigned

Apr 25, 2007

Last updated

Aug 21, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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

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.

• Dental Professionals of Illinois, P.C.

  dba Essington Family Dental Care

  • General Practice Dentistry
  • Joliet, IL
  • NPI 1528271889
  NPD (past)
• Lifetime Dental Care of Illinois, PC

  dba Macomb Dental Center

  • General Practice Dentistry
  • Macomb, IL
  • NPI 1396967741
  NPD (past)
• Lifetime Dental Care of Illinois, PC

  dba 21st Century Dental - Rock Island

  • General Practice Dentistry
  • Rock Island, IL
  • NPI 1831311430
  NPD (past)

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1730308958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 ESSINGTON RD STE 200",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604358410",
            "telephone_number": "815-744-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 ESSINGTON RD STE 200",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604358410",
            "telephone_number": "815-744-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMBASHA",
        "first_name": "FARAI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019026906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maribeth Michelle Kaiser, LSW
• Celeste D. Kaliski, M.D.
• Kalpana T. Shah, DMD, PC (Primary Family Dental)
• Kalpana T. Shah, DMD, PC (Primary Family Dental)
• Mir Ahmed Kamal, DMD
• Kathleen Margaret Kammer, M.H.S. CCC-SLP/L
• Leah Grace Kamp, MOT, OTR/L
• Miriam Kanan, FNP-BC, APN
• Kanchana Esairya-Umpai M D S C
• Kanchana Esariya Umpai,MD,SC.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2026; 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.