Jose Villa DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019021973 Issued in IL

Legal business name

JOSE VILLA DDS PC

Doing business as

Family Dental Care

Practice address

2841 Grand Ave
Waukegan, IL 60085-2372

Phone

(847) 360-1610

Fax

(847) 360-1689

NPI assigned

Apr 2, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Brusela F. Villa

Title

Generalist/Assistant Bookkeeper

Phone

(773) 458-4443

Specialties & licenses 1

Addresses

Other names 1

• Family Dental Care Doing business as

Tax ID family

Family Dental Care2 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.

• Jose Villa PC

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1437301744
  NPD tax ID

Locations

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427932800000",
    "number": "1053706481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2841 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852372",
            "telephone_number": "847-360-1610",
            "fax_number": "847-360-1689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2841 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852372",
            "telephone_number": "847-360-1610",
            "fax_number": "847-360-1689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSE VILLA DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-02",
        "last_updated": "2015-04-02",
        "status": "A",
        "authorized_official_last_name": "VILLA",
        "authorized_official_first_name": "BRUSELA",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "GENERALIST/ASSISTANT BOOKKEEPER",
        "authorized_official_telephone_number": "773-458-4443",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019021973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Antoinette Jones
• Jennifer Marie Jones, M.ED
• Leigh Ann Jones, PA-C
• Sharon D Jones
• Will Jones Jr.
• Jacob Jose
• Erin E Josen
• Joseph E Frydman, MD,SC
• Ashley Joseph, BA
• Ben Joseph

• General Practice Dentistry in Waukegan, IL
• Providers in Waukegan, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.