Individual provider Active NPI

Firdaus Jafri

  • General Practice Dentistry
  • Carol Stream, IL
National Provider Identifier
1790020337
Registry record updated Dec 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019019462 Issued in IL
Practice address
206 N Gary Ave
Carol Stream, IL 60188-1834
Phone
(630) 665-2147
Fax
(630) 665-6980
NPI assigned
Dec 9, 2012
Last updated
Dec 9, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2012

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 019019462 IL Primary

Addresses

Primary practice location

206 N Gary Ave
Carol Stream, IL 60188-1834

Mailing address

206 N Gary Ave
Carol Stream, IL 60188-1834

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
019019462ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Dental Care Inc 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": "1355011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355011200000",
    "number": "1790020337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 N GARY AVE",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601881834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 N GARY AVE",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601881834",
            "telephone_number": "630-665-2147",
            "fax_number": "630-665-6980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFRI",
        "first_name": "FIRDAUS",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-09",
        "last_updated": "2012-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019019462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carol Stream, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2012; 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.