Individual provider Active NPI

Dominique Angele Angibeau, DDS

  • Dentist
  • Chicago, IL
National Provider Identifier
1891471959
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.036772 Issued in IL
Practice address
955 W Monroe St
Chicago, IL 60607-2811
Phone
(312) 248-7416
NPI assigned
Jun 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 40584 TX
Dentist 122300000X 019.036772 IL Primary

Addresses

Primary practice location

955 W Monroe St
Chicago, IL 60607-2811

Mailing address

3407 S Halls Point CT
Missouri City, TX 77459-6578
Phone (281) 435-2818

Other practice location 1

5225 Touhy Ave
Skokie, IL 60077-3245
Phone (847) 807-7341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019.036772ILMDDentist
40584TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mena Dental PLLC PastSince Apr 20, 2025 Accepting new patients
Mithila Sharma DDS PLLC PastSince Nov 9, 2021 Accepting new patients

Organizations & group practices 2

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": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1891471959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3407 S HALLS POINT CT",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774596578",
            "telephone_number": "281-435-2818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 W MONROE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072811",
            "telephone_number": "312-248-7416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5225 Touhy Ave",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "600773245",
            "country_code": "US",
            "telephone_number": "847-807-7341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANGIBEAU",
        "first_name": "DOMINIQUE",
        "middle_name": "ANGELE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-23",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "40584",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.036772",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.