Active NPI
Alexander Scott Fisher, DMD
- General Practice Dentistry
- Chicago, IL
National Provider Identifier
1023546777
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019.032804
- 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, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 019.032804 | IL | MD | General Practice Dentistry |
| 22DI02679300 | NJ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| James D Rohan DDS, PC | General Practice | Past | Accepting new patients |
| Chicago Style Smiles, LLC | General Practice | Past | 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.
-
- General Practice Dentistry
- Chicago, IL
- NPI 1578076352
-
- General Practice Dentistry
- Chicago, IL
- NPI 1548472285
-
- General Practice Dentistry
- Montclair, NJ
- NPI 1598262461
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.