Individual provider Active NPI

Veronica Lynn Dimario, DDS

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1891799508
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019024582 Issued in IL
Practice address
2334 W Lawrence Ave
#208
Chicago, IL 60625-1948
Phone
(773) 271-6168
Fax
(773) 271-7450
NPI assigned
Jun 9, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019024582 IL Primary

Addresses

Primary practice location

2334 W Lawrence Ave
#208
Chicago, IL 60625-1948

Mailing address

2749 W Gidddings St
Unit Ge
Chicago, IL 60625
Phone (773) 484-0777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20161209001197 IN Order and Referring Only - DentistPractitioner - Dentist 0143500074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019024582ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dimario Dental Services General Practice PastSince Jun 21, 2020 Accepting new patients

Organizations & group practices 1

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1891799508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2749 W GIDDDINGS ST",
            "address_2": "UNIT GE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60625",
            "telephone_number": "773-484-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2334 W LAWRENCE AVE",
            "address_2": "#208",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606251948",
            "telephone_number": "773-271-6168",
            "fax_number": "773-271-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMARIO",
        "first_name": "VERONICA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-09",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019024582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.