Organization Active NPI

Excellent Dentistry LTD Inc

  • Dentist
  • Skokie, IL
National Provider Identifier
1073688172
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
EXCELLENT DENTISTRY LTD INC
Practice address
5301 W Dempster
Ste 210
Skokie, IL 60077
Phone
(847) 663-0300
Fax
(847) 663-0332
NPI assigned
Nov 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Victoria Eyber, DDS
Title
President
Phone
(847) 663-0300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X IL Primary

Addresses

Primary practice location

5301 W Dempster
Ste 210
Skokie, IL 60077

Mailing address

5301 W Dempster
Ste 210
Skokie, IL 60077
Phone (847) 663-0300

Other identifiers 1

IdentifierTypeStateIssuer
1001786MedicaidIL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073688172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 W DEMPSTER",
            "address_2": "STE 210",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "60077",
            "telephone_number": "847-663-0300",
            "fax_number": "847-663-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 W DEMPSTER",
            "address_2": "STE 210",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "60077",
            "telephone_number": "847-663-0300",
            "fax_number": "847-663-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELLENT DENTISTRY LTD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EYBER",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-663-0300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1001786",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.