NPIMap

Organization Active NPI

Salud Family Dental

  • Dentist
  • Burbank, IL
National Provider Identifier
1063887404
Registry record updated Dec 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.028486 Issued in IL
Legal business name
SALUD FAMILY DENTAL
Practice address
7714 S Cicero Ave
Burbank, IL 60459-1583
Phone
(708) 636-3368
Fax
(708) 636-7109
NPI assigned
Dec 10, 2015
Last updated
Dec 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2015

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

Authorized official

Name
Asim M Ansari, DDSNPI 1881904670
Title
President
Phone
(630) 254-9114

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.028486 IL Primary

Addresses

Primary practice location

7714 S Cicero Ave
Burbank, IL 60459-1583

Mailing address

7714 S Cicero Ave
Burbank, IL 60459-1583
Phone (708) 636-3368

National Provider Directory

National Provider Directory

Locations

7714 S Cicero Ave
Burbank, IL 60459
Phone (708) 636-3368

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449705600000",
    "number": "1063887404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7714 S CICERO AVE",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604591583",
            "telephone_number": "708-636-3368",
            "fax_number": "708-636-7109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7714 S CICERO AVE",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604591583",
            "telephone_number": "708-636-3368",
            "fax_number": "708-636-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALUD FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-10",
        "last_updated": "2015-12-10",
        "status": "A",
        "authorized_official_last_name": "ANSARI",
        "authorized_official_first_name": "ASIM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-254-9114",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.028486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.