Organization Active NPI

Alaleh Dowlatshahi DDS,Ms,PC

  • Dentist
  • Chicago, IL
National Provider Identifier
1023408374
Registry record updated Jan 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19027868 Issued in IL
Legal business name
ALALEH DOWLATSHAHI DDS,MS,PC
Practice address
3745 N Clark St
Chicago, IL 60613-4780
Phone
(773) 248-0300
NPI assigned
Jan 26, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2015

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

Authorized official

Name
Alaleh Dowlatshahi, DDS
Title
Dentist
Phone
(773) 248-0300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 19027868 IL Primary

Addresses

Primary practice location

3745 N Clark St
Chicago, IL 60613-4780

Mailing address

3745 N Clark St
Chicago, IL 60613-4780
Phone (773) 248-0300

Other identifiers 1

IdentifierTypeStateIssuer
1932349248MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Alaleh Dowlatshahi Ddsmspc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422230400000",
    "number": "1023408374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3745 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606134780",
            "telephone_number": "773-248-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3745 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606134780",
            "telephone_number": "773-248-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALALEH DOWLATSHAHI DDS,MS,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-26",
        "last_updated": "2015-01-26",
        "status": "A",
        "authorized_official_last_name": "DOWLATSHAHI",
        "authorized_official_first_name": "ALALEH",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "773-248-0300",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "19027868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932349248",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; 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.