NPIMap

Organization Active NPI

Perfect Smile P.C.

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1083885271
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019026329 Issued in IL
Legal business name
PERFECT SMILE P.C.
Doing business as
Montrose Ashland Dental Center
Practice address
1624 W Montrose Ave
Chicago, IL 60613-1214
Phone
(773) 275-5600
Fax
(773) 275-5868
NPI assigned
Mar 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Authorized official

Name
Dr. Salman Umar Poothawala, DDS
Title
Dentist
Phone
(773) 275-5600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019026329 IL Primary

Addresses

Primary practice location

1624 W Montrose Ave
Chicago, IL 60613-1214

Mailing address

1624 W Montrose Ave
Chicago, IL 60613-1214
Phone (773) 275-5600

Other names 1

  • Montrose Ashland Dental Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Montrose Ashland Dental Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1624 W Montrose Ave
Chicago, IL 60613
Phone (773) 275-5600

NPI Registry JSON

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1083885271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 W MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131214",
            "telephone_number": "773-275-5600",
            "fax_number": "773-275-5868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 W MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131214",
            "telephone_number": "773-275-5600",
            "fax_number": "773-275-5868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFECT SMILE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-17",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "POOTHAWALA",
        "authorized_official_first_name": "SALMAN",
        "authorized_official_middle_name": "UMAR",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "773-275-5600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019026329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montrose Ashland Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 17, 2008; 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.