Samir Balaney, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

019028291 Issued in IL

Practice address

6301 West Cermak
Berwyn, IL 60402-2368

Phone

(708) 956-7516

NPI assigned

Jun 17, 2010

Last updated

Jun 17, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Sep 25, 2015 through Sep 25, 2027

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brite Dental Berwyn, P.C.

  • Dentist
  • Berwyn, IL
  • NPI 1720332620
  NPD (past)

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276732800000",
    "number": "1821319450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 SOUTH STATE ST",
            "address_2": "#1902",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606051932",
            "telephone_number": "630-915-4046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 WEST CERMAK",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022368",
            "telephone_number": "708-956-7516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALANEY",
        "first_name": "SAMIR",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-17",
        "last_updated": "2010-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019028291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Baidoo, M.D.
• Larry L Bailey, MD
• Breanna Lynn Baker
• John U Baker, LCSW
• James Louis Bakos, D.P.M.
• Blanca M Baldoceda, MD
• Christopher D Bane, M.D.
• Wade Banks Jr.
• Rebecca M Baran, DPT
• Sara E Baranowski, MA CCC-SLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.