Ninos K Awraham, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

019027742 Issued in IL

Practice address

301 E Rand Rd
Mount Prospect, IL 60056-6089

Phone

(847) 818-1118

Fax

(847) 818-8111

NPI assigned

Aug 29, 2008

Last updated

Aug 29, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1219968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219968000000",
    "number": "1881842045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E RAND RD",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600566089",
            "telephone_number": "847-818-1118",
            "fax_number": "847-818-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E RAND RD",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600566089",
            "telephone_number": "847-818-1118",
            "fax_number": "847-818-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWRAHAM",
        "first_name": "NINOS",
        "middle_name": "K",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-29",
        "last_updated": "2008-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Mount Prospect, IL
• Providers in Mount Prospect, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.