Individual provider Active NPI

Rajpaul Singh

  • Dentist
  • Peoria, IL
National Provider Identifier
1861831885
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019029477 Issued in IL
Practice address
7310 N Villa Lake Dr Ste a
Peoria, IL 61614-8268
Phone
(309) 689-0746
Fax
(309) 689-0759
NPI assigned
Jun 24, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019029477 IL Primary

Addresses

Primary practice location

7310 N Villa Lake Dr Ste a
Peoria, IL 61614-8268

Mailing address

7310 N Villa Lake Dr Ste a
Peoria, IL 61614-8268
Phone (309) 689-0746

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20150605001838 IL Order and Referring Only - DentistPractitioner - Dentist 1759602410

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019029477ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Professionals of Illinois, P.C. Past Accepting new patients
Lifetime Dental Care of Illinois, PC Past Accepting new patients
Dental Professionals of Illinois, P.C. Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1861831885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7310 N VILLA LAKE DR STE A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148268",
            "telephone_number": "309-689-0746",
            "fax_number": "309-689-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7310 N VILLA LAKE DR STE A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148268",
            "telephone_number": "309-689-0746",
            "fax_number": "309-689-0759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINGH",
        "first_name": "RAJPAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-24",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.