Individual provider Active NPI

Sunil Kurup, D.D.S.

  • Dentist
  • Chicago, IL
National Provider Identifier
1891930038
Registry record updated Dec 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019027616 Issued in IL
Practice address
430 W Erie St
Ste 200
Chicago, IL 60654-6914
Phone
(920) 838-1649
NPI assigned
Dec 2, 2008
Last updated
Dec 2, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019027616 IL Primary

Addresses

Primary practice location

430 W Erie St
Ste 200
Chicago, IL 60654-6914

Mailing address

4638 Jerome Ave
Skokie, IL 60076-3837
Phone (773) 971-6854

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
019027616ILMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228176000000",
    "number": "1891930038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4638 JEROME AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600763837",
            "telephone_number": "773-971-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 W ERIE ST",
            "address_2": "STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606546914",
            "telephone_number": "920-838-1649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURUP",
        "first_name": "SUNIL",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-02",
        "last_updated": "2008-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027616",
            "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 Dec 2, 2008; 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.