Individual provider Active NPI

Ayesha Husain Pardesi, D.M.D.

  • Dentist
  • Naperville, IL
National Provider Identifier
1801221510
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.031281 Issued in IL
Practice address
4015 Plainfield Naperville Rd
Naperville, IL 60564-4238
Phone
(630) 326-8700
NPI assigned
Sep 12, 2013
Last updated
Apr 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.031281 IL Primary

Addresses

Primary practice location

4015 Plainfield Naperville Rd
Naperville, IL 60564-4238

Mailing address

1508 Cocalico CT
Naperville, IL 60563-2591
Phone (949) 233-3130

Other identifiers 1

IdentifierTypeStateIssuer
1801221510MedicaidIL

Other names 1

  • Ayesha Husain Former name

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
019.031281ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1801221510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 COCALICO CT",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632591",
            "telephone_number": "949-233-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 PLAINFIELD NAPERVILLE RD",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605644238",
            "telephone_number": "630-326-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARDESI",
        "first_name": "AYESHA",
        "middle_name": "HUSAIN",
        "name_prefix": "Mrs.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-12",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.031281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801221510",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AYESHA",
            "last_name": "HUSAIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.