Active NPI
Nooshin Sanaei, DMD
- General Practice Dentistry
- Bolingbrook, IL
National Provider Identifier
1922738343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019.033791
- Practice address
- 210 N Bolingbrook Dr
Bolingbrook, IL 60440-2386 - Phone
- (630) 972-4010
- NPI assigned
- Jun 17, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019.033791 | IL | Primary |
Addresses
Primary practice location
210 N Bolingbrook Dr
Bolingbrook, IL 60440-2386
Mailing address
7804 S Jasper Way
Englewood, CO 80112-4749
Phone (720) 951-2503
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 |
|---|---|---|---|
| 019.033791 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655942400000",
"number": "1922738343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7804 S JASPER WAY",
"city": "ENGLEWOOD",
"state": "CO",
"postal_code": "801124749",
"telephone_number": "720-951-2503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 N BOLINGBROOK DR",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604402386",
"telephone_number": "630-972-4010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANAEI",
"first_name": "NOOSHIN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-17",
"last_updated": "2022-06-23",
"certification_date": "2022-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019.033791",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bolingbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.