Active NPI
Bleidy Marcela Escobar, DDS
- Dentist
- Chicago, IL
National Provider Identifier
1902192495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019.028633
- Practice address
- 4148 S Archer Ave
Chicago, IL 60632-1825 - Phone
- (773) 247-3345
- NPI assigned
- Jun 22, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.028633 | IL | Primary |
Addresses
Primary practice location
4148 S Archer Ave
Chicago, IL 60632-1825
Mailing address
401 W Fullerton Pkwy Apt 606E
Chicago, IL 60614-2802
Phone (773) 391-1478
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019.028633 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Romo Dental, PC | Past | 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.
-
- General Practice Dentistry
- Chicago, IL
- NPI 1073656922
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308700800000",
"number": "1902192495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 W FULLERTON PKWY APT 606E",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606142802",
"telephone_number": "773-391-1478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4148 S ARCHER AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606321825",
"telephone_number": "773-247-3345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESCOBAR",
"first_name": "BLEIDY",
"middle_name": "MARCELA",
"name_prefix": "Miss",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-22",
"last_updated": "2011-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.028633",
"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 Jun 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.