Active NPI
Scott Overholser, D.D.S.
- General Practice Dentistry
- Chicago, IL
National Provider Identifier
1053578260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019026260
- Practice address
- 3115 N Broadway St
Lakeview Dental Arts
Chicago, IL 60657-4522 - Phone
- (773) 270-5000
- Fax
- (872) 206-5337
- NPI assigned
- May 16, 2008
- Last updated
- Dec 8, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019026260 | IL | Primary |
Addresses
Primary practice location
3115 N Broadway St
Lakeview Dental Arts
Chicago, IL 60657-4522
Mailing address
3115 N Broadway St
Lakeview Dental Arts
Chicago, IL 60657-4522
Phone (773) 270-5000
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 |
|---|---|---|---|
| 019026260 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Arts Group PLLC | Current | Accepting new patients | |
| Scott Overholser, DDS P.C. | General Practice | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Lakeview Dental Arts
- General Practice Dentistry
- Chicago, IL
- NPI 1275914848
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481155200000",
"number": "1053578260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3115 N BROADWAY ST",
"address_2": "LAKEVIEW DENTAL ARTS",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606574522",
"telephone_number": "773-270-5000",
"fax_number": "872-206-5337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3115 N BROADWAY ST",
"address_2": "LAKEVIEW DENTAL ARTS",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606574522",
"telephone_number": "773-270-5000",
"fax_number": "872-206-5337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OVERHOLSER",
"first_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-16",
"last_updated": "2016-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019026260",
"primary": true
}
],
"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 Dec 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.