Individual provider Active NPI

Alexander Scott Fisher, DMD

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1023546777
Registry record updated Jan 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.032804 Issued in IL
Practice address
30 N Michigan Ave Ste 1506
Chicago, IL 60602-3689
Phone
(312) 372-4845
NPI assigned
May 25, 2017
Last updated
Jan 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019.032804 IL Primary
General Practice Dentistry 1223G0001X 22DI02679300 NJ

Addresses

Primary practice location

30 N Michigan Ave Ste 1506
Chicago, IL 60602-3689

Mailing address

30 N Michigan Ave Ste 1506
Chicago, IL 60602-3689
Phone (312) 372-4845

Other practice location 1

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-5593

Other practice location 2

39 S Fullerton Ave Fl 2
Montclair, NJ 07042
Phone (908) 655-1919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019.032804ILMDGeneral Practice Dentistry
22DI02679300NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
James D Rohan DDS, PC General Practice PastSince Jan 17, 2021 Accepting new patients
Chicago Style Smiles, LLC General Practice PastSince Jan 17, 2021 Accepting new patients
Montclair Digital Dental General Practice Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609459200000",
    "number": "1023546777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE STE 1506",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023689",
            "telephone_number": "312-372-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE STE 1506",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023689",
            "telephone_number": "312-372-4845"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076011915",
            "country_code": "US",
            "telephone_number": "551-996-5593",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "39 S Fullerton Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Montclair",
            "state": "NJ",
            "postal_code": "07042",
            "country_code": "US",
            "telephone_number": "908-655-1919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FISHER",
        "first_name": "ALEXANDER",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-25",
        "last_updated": "2021-01-01",
        "certification_date": "2021-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.032804",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02679300",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 1, 2021; 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.