Samer Shaltoni, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

021.003033 Issued in IL

Practice address

1411 McHenry Rd Ste 127
Buffalo Grove, IL 60089-1386

Phone

(847) 276-2500

NPI assigned

Aug 13, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1952880684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 STONE CANYON CIR",
            "city": "INVERNESS",
            "state": "IL",
            "postal_code": "600106447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 MCHENRY RD STE 127",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891386",
            "telephone_number": "847-276-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "709 Stone Canyon Cir",
            "address_purpose": "LOCATION",
            "city": "Inverness",
            "state": "IL",
            "postal_code": "600106447",
            "country_code": "US",
            "telephone_number": "630-659-5340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHALTONI",
        "first_name": "SAMER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-13",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019031154",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "021.003033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Buffalo Grove, IL
• Providers in Buffalo Grove, IL by specialty
• Periodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; 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.