32DRS Family Dental 2, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

32DRS FAMILY DENTAL 2, LLC

Practice address

5876 E State St
Rockford, IL 61108-2428

Phone

(847) 250-7784

NPI assigned

Sep 7, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Jacob PhilipNPI 1407261852

Title

Owner

Phone

(847) 250-7784

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacob Philip, DDS

  • General Practice Dentistry
  • Springfield, IL
  • NPI 1407261852
  NPD Authorized official

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662508800000",
    "number": "1003537010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5876 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5876 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082428",
            "telephone_number": "847-250-7784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "32DRS FAMILY DENTAL 2, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A",
        "authorized_official_last_name": "PHILIP",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-250-7784",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Waleed Abbasi, M.D.
• Turkia Mahmud Abbed, M.D.
• Haneen Abdalhadi, MD

• General Practice Dentistry in Rockford, IL
• Providers in Rockford, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.

Verify at the official NPI Registry.