Nastaran Agheli, DDS,MS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019034641 Issued in IL

Practice address

2034 N State Route 50
Bourbonnais, IL 60914-4410

Phone

(815) 929-0222

Fax

(815) 929-0333

NPI assigned

Sep 28, 2023

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

Credentials

Master of Science

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.

• Bradley Dental, LLC

  • General Practice Dentistry
  • Bourbonnais, IL
  • NPI 1295906584

  General Practice

  NPD (past)
• Dental Dreams LLC

  • Dental Clinic/Center
  • Bourbonnais, IL
  • NPI 1083092670
  NPD (past)

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

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1821878786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22120 BROCKSHIRE ST",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483754788",
            "telephone_number": "240-780-6064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2034 N STATE ROUTE 50",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609144410",
            "telephone_number": "815-929-0222",
            "fax_number": "815-929-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGHELI",
        "first_name": "NASTARAN",
        "credential": "DDS,MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-28",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2952000831",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019034641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• James Matthew Adams, DDS
• John Lindley Adams, PHD, NCSP
• Affordable Dentures & Implants - Illinois, PLLC
• Yetunde M Akinde, MD
• Karie Renae Alderson, LCSW
• Peter Alfano
• Eyad Alhaj, MD
• Syeda Farheen Ali, MD

• All providers in Bourbonnais, IL
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.