Dr Sodabeh Etminan, DMD in Chicago, IL - Medicare Dentist Provider

Dr Sodabeh Etminan, DMD is a medicare enrolled "Dentist - General Practice" provider in Chicago, Illinois. Her current practice location is 7131 S Jeffery Blvd Ste A, Chicago, Illinois. You can reach out to her office (for appointments etc.) via phone at (773) 256-0526.

Dr Sodabeh Etminan is licensed to practice in Illinois (license number 019.027979) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1003047929.

Contact Information

	Dr Sodabeh Etminan, DMD
	7131 S Jeffery Blvd Ste A, Chicago, IL 60649-2176
	(773) 256-0526
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Sodabeh Etminan
Gender	Female
Speciality	Dentist - General Practice
Location	7131 S Jeffery Blvd Ste A, Chicago, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1003047929
Provider Enumeration Date: 07/28/2009
Last Update Date: 09/28/2016

Medicare PECOS Information:

PECOS PAC ID: 6406144856
Enrollment ID: I20161018001170

Medical Identifiers

Medical identifiers for Dr Sodabeh Etminan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1003047929	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223G0001X	Dentist - General Practice	019.027979 (Illinois)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Sodabeh Etminan allows following entities to bill medicare on her behalf.

Entity Name	The Board Of Trustees Of The University Of Illinois
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1386863819 PECOS PAC ID: 3072422716 Enrollment ID: O20031112000158

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Sodabeh Etminan is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Sodabeh Etminan, DMD 1220 S Wood St, Chicago, IL 60608-1202 Ph: (312) 413-1789	Dr Sodabeh Etminan, DMD 7131 S Jeffery Blvd Ste A, Chicago, IL 60649-2176 Ph: (773) 256-0526

Reviews and Comments

Dentist in Chicago, IL

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Gandy S Garcia, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 3915 W 26th St, Chicago, IL 60623 Phone: 773-522-2929 Fax: 773-522-2930

Dr Sodabeh Etminan, DMD - Medicare Dentist in Chicago, IL