Aita Koopahi

Primary specialty

DentistTaxonomy code 122300000X

License

019029890 Issued in IL

Practice address

4516 S Damen Ave
Chicago, IL 60609-3013

Phone

(773) 869-0200

NPI assigned

Jul 8, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Studio Dental, LLC

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1629249610
  NPD (past)

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404777600000",
    "number": "1780090043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N CLARK ST FL 6",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606544712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4516 S DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606093013",
            "telephone_number": "773-869-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOPAHI",
        "first_name": "AITA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-08",
        "last_updated": "2014-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019029890",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathaniel Koo
• Erin Nicole Kooiker, PTA
• Joanna Marie Kooistra, M.S., BCBA
• Melissa Koontz
• Rory Koontz, LPC
• Steven George Koopman, M.D.
• Koosha Medical Center P C
• Melika Kooshki Forooshani, MD, MS
• Kooth USA LLC
• Anna K Kopchak

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2014; 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.