Dr. Maryam Moghadam , DDS
Dentist - General Practice • Evanston, IL
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Maryam Moghadam has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Maryam Moghadam, DDS was a registered Dentist - General Practice practicing in Evanston, IL. Throughout an active medical career spanning 20 years, Dr. Moghadam provided care at the practice location at 234 RIDGE AVE until profile deactivation on 2026-06-11.
Practice Location & Contact Primary Location
234 Ridge Ave
#1
Evanston, IL 602023349
Specialty Benchmarks & Practice Insights
Comparative analytics for Dentist - General Practice in Evanston, IL
Practicing in Evanston, IL (5581 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 1223G0001X
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on June 11, 2026
Registered at 22778 E POCO CALLE, QUEEN CREEK, AZ 851421449 (Tel: 8478486339)
Dentist (License #019025836 in IL)
Dentist (License #D010262 in AZ)
NPI status registered as active in NPPES database
Registered at 234 RIDGE AVE, #1, EVANSTON, IL 602023349 (Tel: 8478645491)
Registered at 2556N LARAMIE AVE, CHICAGO, IL 606392452 (Tel: 7738893333)
Recorded as MARYAM MOGHADAM, DDS
Dentist (License #019025836 in IL)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
2556n Laramie Ave
Chicago, IL 606392452
Phone: 7738893333
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