Individual provider Active NPI

Bhakti Desai

  • Pediatric Dentistry
  • Chicago, IL
National Provider Identifier
1891315917
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
019033434 Issued in IL
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

Updated by the provider on Oct 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
019033434OtherILILLINOIS 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221122001765 IL Practitioner - Dentist 1052739687 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of the University of Illinois Pediatric Dentistry CurrentSince Nov 1, 2022 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Nov 1, 2022 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.