Individual provider Active NPI

Andrea Venizelos Nunney, DDS, MS

  • Dentist
  • Chicago, IL
National Provider Identifier
1912255910
Registry record updated Aug 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.029185 Issued in IL
Practice address
801 S Paulina St
Room 304 G
Chicago, IL 60612-7210
Phone
(312) 996-7514
NPI assigned
Aug 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.029185 IL Primary

Addresses

Primary practice location

801 S Paulina St
Room 304 G
Chicago, IL 60612-7210

Mailing address

1234 N Wolcott Ave
Apt 1
Chicago, IL 60622-3882
Phone (216) 470-7767

Other names 1

  • Andrea Venizelos-Nunney Former name

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
019.029185ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1345593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345593600000",
    "number": "1912255910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 N WOLCOTT AVE",
            "address_2": "APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223882",
            "telephone_number": "216-470-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S PAULINA ST",
            "address_2": "ROOM 304 G",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127210",
            "telephone_number": "312-996-7514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNNEY",
        "first_name": "ANDREA",
        "middle_name": "VENIZELOS",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-22",
        "last_updated": "2012-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.029185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "VENIZELOS-NUNNEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Aug 22, 2012; 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.