Individual provider Active NPI

Preeti Iyer Das, D.D.S

  • Dentist
  • Chicago, IL
National Provider Identifier
1851706964
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.031798 Issued in IL
Practice address
111 W. Jackson
Ste 1410
Chicago, IL 60604
Phone
(312) 939-2400
NPI assigned
Jun 26, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901021220 MI
Dentist 122300000X 019.031798 IL Primary

Addresses

Primary practice location

111 W. Jackson
Ste 1410
Chicago, IL 60604

Mailing address

2705 N Artesian Ave
Unit 1
Chicago, IL 60647

Other names 1

  • Preeti Iyer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20150522002454 MI Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 6204156789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.031798ILMDDentist
2901021220MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Staci Sikora and Associates CurrentSince Mar 5, 2023 Accepting new patients
Metropolitan Dental Center of Pontiac PC Dentist Past Accepting new patients

Locations

111 W Jackson Blvd
Ste 1410
Chicago, IL 60604
Phone (312) 939-2400

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.

NPI Registry JSON

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1851706964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 N ARTESIAN AVE",
            "address_2": "UNIT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W. JACKSON",
            "address_2": "STE 1410",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60604",
            "telephone_number": "312-939-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAS",
        "first_name": "PREETI",
        "middle_name": "IYER",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-26",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021220",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.031798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PREETI",
            "last_name": "IYER",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.