Active NPI
Tamara Marjan, DMD
- Dentist
- Tinley Park, IL
National Provider Identifier
1841783651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019.031700
- Practice address
- 15909 Harlem Ave
Tinley Park, IL 60477-1609 - Phone
- (708) 429-0915
- NPI assigned
- Jun 7, 2018
- Last updated
- Jun 7, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.031700 | IL | Primary |
Addresses
Primary practice location
15909 Harlem Ave
Tinley Park, IL 60477-1609
Mailing address
340 E Randolph St Unit 205
Chicago, IL 60601-7418
Phone (936) 239-0753
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019.031700 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Minty Dental Boutique | Current | Accepting new patients | |
| Illinois Dental Providers (Tinley Park), LTD. | Dentist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dental Clinic/Center
- Chicago, IL
- NPI 1457187775
-
- Dentist
- Tinley Park, IL
- NPI 1508837709
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528329600000",
"number": "1841783651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 E RANDOLPH ST UNIT 205",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606017418",
"telephone_number": "936-239-0753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15909 HARLEM AVE",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604771609",
"telephone_number": "708-429-0915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARJAN",
"first_name": "TAMARA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-07",
"last_updated": "2018-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.031700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tinley Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.