Individual provider Active NPI

Sara Anwar, D.D.S

  • General Practice Dentistry
  • Joliet, IL
National Provider Identifier
1902191208
Registry record updated Dec 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019028659 Issued in IL
Practice address
1502 Kempton St
Joliet, IL 60431-8077
Phone
(815) 600-9980
NPI assigned
Jun 14, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2013

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 019028659 IL Primary

Addresses

Primary practice location

1502 Kempton St
Joliet, IL 60431-8077

Mailing address

1502 Kempton St
Joliet, IL 60431-8077
Phone (815) 600-9980

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
019028659ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386201600000",
    "number": "1902191208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 KEMPTON ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604318077",
            "telephone_number": "815-600-9980",
            "fax_number": "630-271-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 KEMPTON ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604318077",
            "telephone_number": "815-600-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANWAR",
        "first_name": "SARA",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2013-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019028659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2013; 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.