Individual provider Active NPI

Bianca Malin, DDS

  • General Practice Dentistry
  • Mount Prospect, IL
National Provider Identifier
1770654253
Registry record updated Feb 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019025072 Issued in IL
Practice address
322 N Wolf Rd
Mt Prospect, IL 60056-2735
Phone
(847) 824-5151
Fax
(847) 824-8981
NPI assigned
Nov 13, 2006
Last updated
Feb 11, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2015

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 019025072 IL Primary

Addresses

Primary practice location

322 N Wolf Rd
Mt Prospect, IL 60056-2735

Mailing address

322 N Wolf Rd
Mt Prospect, IL 60056-2735
Phone (847) 824-5151

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
019025072ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Malin Botvinnik DDS PC General Practice 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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423612800000",
    "number": "1770654253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 N WOLF RD",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600562735",
            "telephone_number": "847-824-5151",
            "fax_number": "847-824-8981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 N WOLF RD",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600562735",
            "telephone_number": "847-824-5151",
            "fax_number": "847-824-8981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIN",
        "first_name": "BIANCA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2015-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Prospect, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; 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.