Shaddai Dental Care

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SHADDAI DENTAL CARE

Practice address

4725 W Fullerton Ave
Chicago, IL 60639-1817

Phone

(773) 987-2345

NPI assigned

Oct 1, 2021

Organization subpart

No

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

Authorized official

Name

Thu Nguyen, DDSNPI 1861686479

Title

President

Phone

(773) 837-6176

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thu Huong Nguyen, DDS

  • Dentist
  • Chicago, IL
  • NPI 1861686479
  NPD Authorized official

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633046400000",
    "number": "1093487662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5324 N ELSTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606301611",
            "telephone_number": "773-837-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391817",
            "telephone_number": "773-987-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADDAI DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-01",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "THU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-837-6176",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruta M Shabez, APRN, CRNA
• Samuel Shabsin, LSW, MSW
• Shachat Dental Group PLLC
• Matthew Shachat, DMD
• Sarah O'Hare Shackleton, PT
• Jennifer Shadden, O.T
• Yvonne Shade Zeldow, PHD
• Shades of Hope LLC
• Hazar Shadid
• Yara Shadid, LSW

• Dental Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; 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.