Jaspreet Kaur Dhingra-Bajaj, D.D.S
Individual provider Active NPI Dentist · Villa Park, IL
NPI 1881842979 · NPPES record last updated May 14, 2015
Key facts
- NPI
- 1881842979
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 019.027728 (IL)
- Practice address
- 100 E Roosevelt Rd
Suite #14
Villa Park, IL 60181-3529 - Phone
- (630) 930-2553
- Fax
- (630) 501-0401
- NPI assigned
- Sep 3, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150603000039 | IL | Order and Referring Only - Dentist |
5991026908 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.027728 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jaspreet Dhingra-Bajaj, LTD | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.027728 | IL | Yes |
| General Practice Dentistry | 1223G0001X | 019.027728 | IL |
Addresses
Primary practice location
100 E Roosevelt Rd
Suite #14
Villa Park, IL 60181-3529
Mailing address
100 E Roosevelt Rd
Suite #14
Villa Park, IL 60181-3529
Phone (630) 930-2553
Other providers in Villa Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.