Chanbo Sim, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12009372A Issued in IN

Practice address

6075 Cleveland Circle
Merrillville, IN 46410

Phone

(219) 980-0319

Fax

(219) 980-0379

NPI assigned

Dec 13, 2006

Last updated

Nov 30, 2020By 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 IN

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Dental Care PC

  • Dentist
  • Merrillville, IN
  • NPI 1952462657
  Medicare reassignment Authorized official
• Smiles on Randolph PC

  • Dental Clinic/Center
  • Merrillville, IN
  • NPI 1295330587
  NPD
• Smiles on North PC

  dba Bucktown Wicker Park Dental

  • Dental Clinic/Center
  • Chicago, IL
  • NPI 1629812789
  NPD

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1760543466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6075 CLEVELAND CIRCLE",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "46410",
            "telephone_number": "219-980-0319",
            "fax_number": "219-980-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6075 CLEVELAND CIRCLE",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "46410",
            "telephone_number": "219-980-0319",
            "fax_number": "219-980-0379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIM",
        "first_name": "CHANBO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12009372A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohammad S Shukairy, M.D.
• Michelle Shumaker, MSW, LCSW
• Anastasia Karabatsos Siatras, D.O.
• Signet Health Products Inc
• Vanessa B. Silverio, FNP-C
• Angela Simmons, CADAC II, MATS
• Brittany Simon
• Magen Simon
• Simply Health Diagnostics LLP
• Paula Simpson, OTR

• Dentist in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.