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EDWIN W MANGRAM II D.D.S.
NPI 1003853425
Dentist in Chicago, IL

Active since June 02, 2006PECOS Enrolled
3860 W OGDEN AVE, CHICAGO, IL 60623(872) 588-3000(872) 588-3021 Get Directions Write a Review

NPPES record last updated: November 16, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Edwin W Mangram Ii D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDWIN W MANGRAM II D.D.S. (NPI 1003853425) is an individual dentist in Chicago, Illinois, licensed in Illinois (019-025445) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003853425
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameEDWIN W MANGRAM IICredential: D.D.S.
Location Address3860 W OGDEN AVEChicago, IL 60623-2460
Mailing Address3860 W Ogden AveChicago, IL 60623-2460 · (872) 588-3000 · Fax (872) 588-3021
Phone(872) 588-3000
Fax(872) 588-3021
Sole ProprietorNo
Enumeration DateJune 2, 2006
Last NPPES UpdateNovember 16, 2012
✔ NPI 1003853425 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in IL · 019-025445
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
3860 W OGDEN AVE, Chicago, IL 60623
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Other Identifiers 2

Medicare UPINU84662IL
Medicare PIN702300IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Edwin W Mangram Ii D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60623 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$74.80 typical visit price
range $18.97 – $148.12
Typical copayment $18.70 (range $4.74 – $37.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOONGYU DANIEL SONG MD
Internal Medicine
3860 W OGDEN AVE
CHICAGO, IL 60623
Cook County (872) 588-3000
ANNA TORNQUIST
Counselor (Professional)
3860 W OGDEN AVE
CHICAGO, IL 60623
Cook County (872) 588-3000
DR. ALISHA RONETTE TILLMAN DO
Family Medicine
3860 W OGDEN AVE
CHICAGO, IL 60623
Cook County (872) 588-3000
DR. THOMAS W BOCKLE M.D.
Pediatrics
3860 W OGDEN AVE
CHICAGO, IL 60623
Cook County (872) 588-3000
LINDSAY J MCCRACKEN P.A.-C
Physician Assistant
3860 W OGDEN AVE
CHICAGO, IL 60623
Cook County (872) 588-3000
LISA ANNE WERNER PA
Physician Assistant
3860 W OGDEN AVE
CHICAGO, IL 60623
Cook County (872) 588-3000
MRS. HEIDI MILLER NP
Nurse Practitioner
3860 W OGDEN AVE
CHICAGO, IL 60623
Cook County (872) 588-3000
DR. KARA W GREELEY M.D.
Family Medicine
3860 W OGDEN AVE
CHICAGO, IL 60623
Cook County (872) 588-3000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edwin Mangram's NPI number?

The NPI number for Edwin Mangram is 1003853425. It was assigned to this individual provider in the NPPES registry on June 2, 2006.

Where is Edwin Mangram located?

Edwin Mangram practices at 3860 W Ogden Ave, Chicago, IL 60623. The listed phone number is (872) 588-3000.

What is Edwin Mangram's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Edwin Mangram enrolled in Medicare?

Yes. Edwin Mangram is registered in the Medicare PECOS enrollment system.

What insurance does Edwin Mangram accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 6 other insurers list Edwin Mangram as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Edwin Mangram was last updated on November 16, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.