Individual provider Active NPI

Michael Bukumira

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1851590582
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
2358 N Lincoln Ave
Chicago, IL 60614-3321
Phone
(773) 327-4442
Fax
(773) 327-7725
NPI assigned
Jul 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X IL Primary

Addresses

Primary practice location

2358 N Lincoln Ave
Chicago, IL 60614-3321

Mailing address

2358 N Lincoln Ave
Chicago, IL 60614-3321
Phone (773) 327-4442

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
364243237ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1851590582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2358 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143321",
            "telephone_number": "773-327-4442",
            "fax_number": "773-327-7725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2358 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143321",
            "telephone_number": "773-327-4442",
            "fax_number": "773-327-7725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUKUMIRA",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-12",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.