Individual provider Active NPI

Alan S Kushner, D.D.S

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1881794923
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19A14607 Issued in IL
Practice address
205 N Michigan Ave
2214
Chicago, IL 60601-5927
Phone
(312) 819-1460
Fax
(312) 819-1491
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 19A14607 IL Primary

Addresses

Primary practice location

205 N Michigan Ave
2214
Chicago, IL 60601-5927

Mailing address

205 N Michigan Ave
2214
Chicago, IL 60601-5927
Phone (312) 819-1460

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
I20150702002079 IL Order and Referring Only - DentistPractitioner - Dentist 7618289661

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19A14607ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kushner Becker and Associates LTD Past Accepting new patients

Organizations & group practices 1

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881794923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N MICHIGAN AVE",
            "address_2": "2214",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606015927",
            "telephone_number": "312-819-1460",
            "fax_number": "312-819-1491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N MICHIGAN AVE",
            "address_2": "2214",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606015927",
            "telephone_number": "312-819-1460",
            "fax_number": "312-819-1491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSHNER",
        "first_name": "ALAN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19A14607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.