Individual provider Active NPI

Ami D Pandya, DDS

  • Dentist
  • Chicago, IL
National Provider Identifier
1871942748
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
319021296 Issued in IL
Practice address
1701 W. Superior
Chicago, IL 60622
Phone
(312) 666-3494
Fax
(312) 432-4354
NPI assigned
Jun 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 319021296 IL Primary

Addresses

Primary practice location

1701 W. Superior
Chicago, IL 60622

Mailing address

1701 W. Superior Street
Chicago, IL 60622
Phone (312) 666-3494

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
I20190131001063 IL Practitioner - Oral Surgery 0840570305 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
319021296ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Erie Family Health Center, Inc Current Accepting new patients
Erie Family Health Center Inc CurrentSince Jan 7, 2019 Accepting new patients
Erie Family Health Center Inc CurrentSince Jan 7, 2019 Accepting new patients

Locations

1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-7381

1504 S Albany Ave
Chicago, IL 60623

5215 N California Ave
Ste F700
Chicago, IL 60625

1701 W Superior St
Chicago, IL 60622
Phone (312) 432-7392

Interoperability endpoints

  • Direct secure messaging: apandya368726@direct.ochin.org

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": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1871942748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W. SUPERIOR STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60622",
            "telephone_number": "312-666-3494",
            "fax_number": "312-432-4354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W. SUPERIOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60622",
            "telephone_number": "312-666-3494",
            "fax_number": "312-432-4354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDYA",
        "first_name": "AMI",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-10",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "319021296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.