Individual provider Active NPI

Arda Paylan, DDS

  • Dentist
  • Morton Grove, IL
National Provider Identifier
1912286535
Registry record updated Aug 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019028699 Issued in IL
Practice address
5821 Dempster St
Morton Grove, IL 60053-3028
Phone
(847) 581-1942
NPI assigned
Aug 13, 2011
Last updated
Aug 13, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019028699 IL Primary

Addresses

Primary practice location

5821 Dempster St
Morton Grove, IL 60053-3028

Mailing address

9621 Le Claire Ave
Skokie, IL 60077-1221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160311000460 TX Order and Referring Only - DentistPractitioner - Dentist 0244536670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019028699ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dentistry at Morton Grove Dentist 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1313193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313193600000",
    "number": "1912286535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9621 LE CLAIRE AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5821 DEMPSTER ST",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600533028",
            "telephone_number": "847-581-1942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYLAN",
        "first_name": "ARDA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-13",
        "last_updated": "2011-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019028699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton Grove, IL

Sources for this page

Verify at the official NPI Registry.