Randi Elyn Smulson, 019027653

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019027653 Issued in IL

Practice address

1725 W North Ave
Suite 102
Chicago, IL 60622-2188

Phone

(773) 227-1048

Fax

(773) 227-3218

NPI assigned

Sep 29, 2008

Sex

Female

Sole proprietor

No

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)

Not 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 and National Provider Directory roles.

• Damen North Dental Group LTD

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1083623201
  NPD (past)

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233532800000",
    "number": "1780834580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W NORTH AVE",
            "address_2": "SUITE 102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222188",
            "telephone_number": "773-227-1048",
            "fax_number": "773-227-3218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W NORTH AVE",
            "address_2": "SUITE 102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222188",
            "telephone_number": "773-227-1048",
            "fax_number": "773-227-3218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMULSON",
        "first_name": "RANDI",
        "middle_name": "ELYN",
        "credential": "019027653",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-29",
        "last_updated": "2009-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027653",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019027653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Smrha, DO
• Ryan SMRZ, PT, DPT
• Craig Smuda, M.D. PH.D.
• Daniel Smulson, DDS
• Paul A Smulson, D.D.S.
• Thomas Smurr, RD
• Agnieszka K Smyk-Horvath, DDS
• Jasmine Smyles, PT, DPT
• Nakeisha N Smyles
• Jordan Smyser

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2009; 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.