Active NPI
Adham Raji Badwan, DMD
- Dentist
- Orland Park, IL
National Provider Identifier
1922475862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019.030453
- Practice address
- 8752 W 159TH St
Orland Park, IL 60462-4891 - Phone
- (708) 403-3900
- NPI assigned
- Aug 26, 2015
- Sex
- Male
- 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 | 019.030453 | IL | Primary |
Addresses
Primary practice location
8752 W 159TH St
Orland Park, IL 60462-4891
Mailing address
17324 Avon LN
Tinley Park, IL 60487-2203
Phone (708) 856-7175
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 |
|---|---|---|---|
| 019.030453 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orland Park Amazing Dental | Dentist | Past | Accepting new patients |
| Ramaha Dental | 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.
-
- General Practice Dentistry
- Orland Park, IL
- NPI 1598329567
-
- General Practice Dentistry
- Orland Park, IL
- NPI 1326210253
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440547200000",
"number": "1922475862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17324 AVON LN",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604872203",
"telephone_number": "708-856-7175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8752 W 159TH ST",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604624891",
"telephone_number": "708-403-3900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BADWAN",
"first_name": "ADHAM",
"middle_name": "RAJI",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-08-26",
"last_updated": "2015-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.030453",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.