Individual provider Active NPI

Kim Tapiawala, DDS

  • Dentist
  • Chicago, IL
National Provider Identifier
1811696172
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.036498 Issued in IL
Practice address
2750 W North Ave
Chicago, IL 60647-5247
Phone
(312) 666-3494
NPI assigned
Feb 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.036498 IL Primary
Dentist 122300000X 39696 TX

Addresses

Primary practice location

2750 W North Ave
Chicago, IL 60647-5247

Mailing address

4437 Riptide LN
Plano, TX 75024-7045
Phone (469) 243-7454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260114000653 IL Practitioner - Dentist 8527544113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1701 W Superior St
FL 3
Chicago, IL 60622-5646

7440 Mintwood LN
Spring, TX 77379-1100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39696TXMDClinical Psychologist
019.036498ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Erie Family Health Center Inc CurrentSince Dec 8, 2025 Accepting new patients
Erie Family Health Center, Inc CurrentSince Dec 8, 2025 Accepting new patients

Locations

1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-7381

1504 S Albany Ave
Chicago, IL 60623

2750 W North Ave
Chicago, IL 60647
Phone (312) 432-2767

1701 W Superior St
Fl 2
Chicago, IL 60622
Phone (323) 361-2122

1701 W Superior St
Chicago, IL 60622
Phone (312) 432-7392

Organizations & group practices 3

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": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1811696172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4437 RIPTIDE LN",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750247045",
            "telephone_number": "469-243-7454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475247",
            "telephone_number": "312-666-3494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAPIAWALA",
        "first_name": "KIM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.036498",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "39696",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.