Individual provider Active NPI

Girishkumar Bapalal Vaidya, D.D.S.

  • Dentist
  • Chicago, IL
National Provider Identifier
1912168030
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019017965 Issued in IL
Practice address
3900 W Madison St
Suite 12
Chicago, IL 60624-2354
Phone
(773) 533-4323
Fax
(773) 533-0531
NPI assigned
Jun 20, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 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 019017965 IL Primary

Addresses

Primary practice location

3900 W Madison St
Suite 12
Chicago, IL 60624-2354

Mailing address

3900 W Madison St
Suite 12
Chicago, IL 60624-2354
Phone (773) 533-4323

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
019017965ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
G B Vaidya DDS PC Dentist Past Accepting new patients
Ami G Vaidya DMD SC Past Accepting new patients

Organizations & group practices 2

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": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213920000000",
    "number": "1912168030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 W MADISON ST",
            "address_2": "SUITE 12",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606242354",
            "telephone_number": "773-533-4323",
            "fax_number": "773-533-0531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 W MADISON ST",
            "address_2": "SUITE 12",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606242354",
            "telephone_number": "773-533-4323",
            "fax_number": "773-533-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAIDYA",
        "first_name": "GIRISHKUMAR",
        "middle_name": "BAPALAL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-20",
        "last_updated": "2008-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019017965",
            "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 20, 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.