Active NPI
Ghayda Ali
- Dentist
- Burr Ridge, IL
National Provider Identifier
1902655152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019.035093
- Practice address
- 9011 Skyline Dr
Burr Ridge, IL 60527-6252 - Phone
- (708) 336-0174
- NPI assigned
- May 17, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 019.035093 | IL | Primary |
Addresses
Primary practice location
9011 Skyline Dr
Burr Ridge, IL 60527-6252
Mailing address
9011 Skyline Dr
Burr Ridge, IL 60527-6252
Phone (708) 336-0174
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 |
|---|---|---|---|
| 019.035093 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719792000000",
"number": "1902655152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9011 SKYLINE DR",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605276252",
"telephone_number": "708-336-0174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9011 SKYLINE DR",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605276252",
"telephone_number": "708-336-0174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALI",
"first_name": "GHAYDA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-17",
"last_updated": "2024-07-01",
"certification_date": "2024-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "IL",
"license": "019.035093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burr Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.