Individual provider Active NPI

Rizwana Maskatiya, D.D.S.

  • Dentist
  • Chicago, IL
National Provider Identifier
1780087619
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019030060 Issued in IL
Practice address
1933 W Irving Park Rd Ste 1
Chicago, IL 60613-5182
Phone
(773) 857-2280
NPI assigned
Oct 7, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 019.030060 IL
Dentist 122300000X 019030060 IL Primary

Addresses

Primary practice location

1933 W Irving Park Rd Ste 1
Chicago, IL 60613-5182

Mailing address

1933 W Irving Park Rd Ste 1
Chicago, IL 60613-5182

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
019030060ILMDDentist
019.030060ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Teeth Boutique PLLC General Practice CurrentSince Sep 15, 2024 Accepting new patients

Locations

1933 W Irving Park Rd
Ste 1
Chicago, IL 60613
Phone (773) 857-2280

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1780087619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1933 W IRVING PARK RD STE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1933 W IRVING PARK RD STE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135182",
            "telephone_number": "773-857-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASKATIYA",
        "first_name": "RIZWANA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-07",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.030060",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019030060",
            "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 Sep 11, 2024; 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.