Reznikov Dental, PC

Primary specialty

DentistTaxonomy code 122300000X

License

019029473 Issued in IL

Legal business name

REZNIKOV DENTAL, PC

Practice address

1556 S Michigan Ave
Ste 110
Chicago, IL 60605-1937

Phone

(312) 588-0043

Fax

(312) 588-0287

NPI assigned

May 11, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Alexander Reznikov, DDS

Title

Owner/Dentist

Phone

(847) 877-3570

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431302400000",
    "number": "1073991162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1556 S MICHIGAN AVE",
            "address_2": "STE 110",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60605",
            "telephone_number": "312-588-0043",
            "fax_number": "312-588-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1556 S MICHIGAN AVE",
            "address_2": "STE 110",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606051937",
            "telephone_number": "312-588-0043",
            "fax_number": "312-588-0287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REZNIKOV DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-11",
        "last_updated": "2015-05-11",
        "status": "A",
        "authorized_official_last_name": "REZNIKOV",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "847-877-3570",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029473",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kourosh Rezania
• Othman Rezki, DMD
• Melinda Rezman, MA
• Joseph Reznicek, MD
• Jane Reznik
• Alexander Reznikov, D.D.S.
• Abdolmajid T. Rezvan, M.D.
• Rhapsody Behavioral Healthcare
• Mercedes Rhea, LCPC, NCC
• Charles Rhee

• Dentist in Chicago, IL
• Providers in Chicago, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.