Active NPI
Bhakti Desai
- Pediatric Dentistry
- Chicago, IL
National Provider Identifier
1891315917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 019033434
- Practice address
- 801 S Paulina St
Chicago, IL 60612-7210 - Phone
- (312) 996-7555
- NPI assigned
- Apr 18, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Dentistry | 1223P0221X | 019033434 | IL | Primary |
Addresses
Primary practice location
801 S Paulina St
Chicago, IL 60612-7210
Mailing address
801 South Paulina
269-H MC 850
Chicago, IL 60612
Phone (205) 542-1717
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019033434 | Other | IL | ILLINOIS STATE DENTAL LICENSE |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Board of Trustees of the University of Illinois | Pediatric Dentistry | Current | Accepting new patients |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients |
Locations
801 S Paulina St
Chicago, IL 60612
Phone (312) 996-1052
7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290
801 S Paulina St
#621
Chicago, IL 60612
Phone (312) 355-1661
801 S Paulina St
#269H
Chicago, IL 60612
Interoperability endpoints
- bdesai69284@uihealth.direct-ci.com
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.
-
- Anatomic Pathology Physician
- Chicago, IL
- NPI 1386863819
-
- Dentist
- Chicago, IL
- NPI 1992873921
-
- Occupational Medicine Physician
- Chicago, IL
- NPI 1043727571
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665014400000",
"number": "1891315917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 SOUTH PAULINA",
"address_2": "269-H MC 850",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60612",
"telephone_number": "205-542-1717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 S PAULINA ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606127210",
"telephone_number": "312-996-7555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESAI",
"first_name": "BHAKTI",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-18",
"last_updated": "2022-10-06",
"certification_date": "2022-10-06",
"status": "A"
},
"taxonomies": [
{
"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": "019033434",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ILLINOIS STATE DENTAL LICENSE",
"identifier": "019033434",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.