NPIMap

Organization Active NPI

Bloomingdale Dental Rez, PC

  • Dentist
  • Bloomingdale, IL
National Provider Identifier
1043750714
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019029473 Issued in IL
Legal business name
BLOOMINGDALE DENTAL REZ, PC
Practice address
1 Tiffany PT Ste 209
Bloomingdale, IL 60108-2916
Phone
(630) 671-0700
Fax
(630) 671-0546
NPI assigned
Mar 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

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

Authorized official

Name
Alexander Reznikov, DDS
Title
President
Phone
(847) 877-3570

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 019029473 IL Primary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X 019023898 IL

Addresses

Primary practice location

1 Tiffany PT Ste 209
Bloomingdale, IL 60108-2916

Mailing address

1 Tiffany PT Ste 209
Bloomingdale, IL 60108-2916
Phone (630) 671-0700

Other names 1

  • Minalt & Wojcicki Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488326400000",
    "number": "1043750714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TIFFANY PT STE 209",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082916",
            "telephone_number": "630-671-0700",
            "fax_number": "630-671-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TIFFANY PT STE 209",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082916",
            "telephone_number": "630-671-0700",
            "fax_number": "630-671-0546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMINGDALE DENTAL REZ, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-01",
        "last_updated": "2017-03-01",
        "status": "A",
        "authorized_official_last_name": "REZNIKOV",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-877-3570",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029473",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "019023898",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Minalt & Wojcicki Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomingdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; 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.