Active NPI
Niloufar Ghazal, DMD
- Dentist
- Lockport, IL
National Provider Identifier
1972025112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019031246
- Practice address
- 16620 W 159TH St
Lockport, IL 60441-8012 - Phone
- (815) 552-2360
- Fax
- (815) 552-2963
- NPI assigned
- Jul 10, 2017
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 019031246 | IL | Primary |
Addresses
Primary practice location
16620 W 159TH St
Lockport, IL 60441-8012
Mailing address
16620 W 159TH St
Lockport, IL 60441-8012
Phone (815) 552-2360
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 |
|---|---|---|---|
| 019031246 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1972025112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16620 W 159TH ST",
"city": "LOCKPORT",
"state": "IL",
"postal_code": "604418012",
"telephone_number": "815-552-2360",
"fax_number": "815-552-2963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16620 W 159TH ST",
"city": "LOCKPORT",
"state": "IL",
"postal_code": "604418012",
"telephone_number": "815-552-2360",
"fax_number": "815-552-2963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHAZAL",
"first_name": "NILOUFAR",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-10",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019031246",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lockport, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.