NPIMap

Organization Active NPI

Romo Dental, PC

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1073656922
Registry record updated Nov 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ROMO DENTAL, PC
Practice address
4148 S Archer Ave
Chicago, IL 60632-1825
Phone
(773) 247-3345
NPI assigned
Feb 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2010

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

Authorized official

Name
Dr. Genaro Romo Jr.NPI 1811978471
Title
D.D.S.
Phone
(773) 247-3345

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
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

4148 S Archer Ave
Chicago, IL 60632-1825

Mailing address

4148 S Archer Ave
Chicago, IL 60632-1825
Phone (773) 247-3345

Other identifiers 2

IdentifierTypeStateIssuer
9180843MedicaidIL
1003508MedicaidIL

National Provider Directory

National Provider Directory

Locations

4148 S Archer Ave
Chicago, IL 60632
Phone (773) 247-3345

Practitioners & affiliated clinicians

Practitioners 6

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": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291075200000",
    "number": "1073656922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4148 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606321825",
            "telephone_number": "773-247-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4148 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606321825",
            "telephone_number": "773-247-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROMO DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2010-11-30",
        "status": "A",
        "authorized_official_last_name": "ROMO",
        "authorized_official_first_name": "GENARO",
        "authorized_official_title_or_position": "D.D.S.",
        "authorized_official_telephone_number": "773-247-3345",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9180843",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003508",
            "state": "IL"
        }
    ],
    "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 Nov 30, 2010; 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.