Merva Razzak

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

021.003293 Issued in IL

Practice address

16906 Oak Park Ave
Tinley Park, IL 60477-3075

Phone

(708) 444-7645

NPI assigned

Jun 25, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Dr. Robert Thies, D.D.S., P.C.

  • General Practice Dentistry
  • Tinley Park, IL
  • NPI 1447264783
  NPD (past)

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1871163576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2113 DALY LN",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605862565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16906 OAK PARK AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604773075",
            "telephone_number": "708-444-7645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1355 E Ogden Ave",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605631630",
            "country_code": "US",
            "telephone_number": "630-687-9292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAZZAK",
        "first_name": "MERVA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-25",
        "last_updated": "2023-10-03",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "019.034633",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "021.003293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sumathi M Rangineni, MD
• Subramanya Rao, M.D.
• Michael Rauwolf, PT
• Kathleen Raven, OT
• Hillary Ann Ray, MA, LPC, NCC
• Rci (WRS), LLC.
• Rd Woods MD LLC
• Recover at Home Inc
• Recover at Home Inc
• Michealene M Redemske, APRN

• Pediatric Dentistry in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Pediatric Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.