NPIMap

Organization Active NPI

Peter M. Jurkash, D.D.S.,P.C.

  • Dental Clinic/Center
  • South Holland, IL
National Provider Identifier
1023257433
Registry record updated Feb 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
019017211 Issued in IL
Legal business name
PETER M. JURKASH, D.D.S.,P.C.
Practice address
15475 S Park Ave
Suite 101
South Holland, IL 60473-1328
Phone
(708) 596-9400
NPI assigned
Feb 9, 2009
Last updated
Feb 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2009

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

Authorized official

Name
Dr. Peter M Jurkash, DDS
Title
President
Phone
(708) 596-9400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 019017211 IL Primary

Addresses

Primary practice location

15475 S Park Ave
Suite 101
South Holland, IL 60473-1328

Mailing address

PO Box 07218
Fort Myers, FL 33919-0218
Phone (708) 596-9400

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234137600000",
    "number": "1023257433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 07218",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339190218",
            "telephone_number": "708-596-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15475 S PARK AVE",
            "address_2": "SUITE 101",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604731328",
            "telephone_number": "708-596-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER M. JURKASH, D.D.S.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-09",
        "last_updated": "2009-02-09",
        "status": "A",
        "authorized_official_last_name": "JURKASH",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-596-9400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019017211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Holland, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2009; 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.