Individual provider Active NPI

Amit Sud, DDS

  • General Practice Dentistry
  • Naperville, IL
National Provider Identifier
1972647295
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019026849 Issued in IL
Practice address
2879 95TH St Ste 131
Naperville, IL 60564-9008
Phone
(630) 753-9955
Fax
(630) 753-9966
NPI assigned
Feb 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019026849 IL Primary

Addresses

Primary practice location

2879 95TH St Ste 131
Naperville, IL 60564-9008

Mailing address

2879 W 95TH St Ste 131
Naperville, IL 60564-9008
Phone (630) 753-9955

Other practice location 1

2309 63rd St
Woodridge, IL 60517-1300
Phone (630) 869-0069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20160525000062 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9739478157

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019026849ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Amit Sud DDS @ Anita Verma DDS General Practice PastSince Mar 11, 2025 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1972647295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2879 W 95TH ST STE 131",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605649008",
            "telephone_number": "630-753-9955",
            "fax_number": "630-753-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2879 95TH ST STE 131",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605649008",
            "telephone_number": "630-753-9955",
            "fax_number": "630-753-9966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2309 63rd St",
            "address_purpose": "LOCATION",
            "city": "Woodridge",
            "state": "IL",
            "postal_code": "605171300",
            "country_code": "US",
            "telephone_number": "630-869-0069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUD",
        "first_name": "AMIT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019026849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.