School House Dental Service

Primary specialty

DentistTaxonomy code 122300000X

License

019016584 Issued in IL

Legal business name

SCHOOL HOUSE DENTAL SERVICE

Practice address

2000 W 95TH St
Chicago, IL 60643-1116

Phone

(773) 881-3911

Fax

(773) 881-4058

NPI assigned

Jul 22, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jerrold W. Smith, D.D.S.NPI 1396892030

Title

President

Phone

(773) 881-3911

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Jerrold Wayne Smith, D.D.S.

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1396892030
  NPD (past) Authorized official

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1104081884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 W 95TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431116",
            "telephone_number": "773-881-3911",
            "fax_number": "773-881-4058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W 95TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431116",
            "telephone_number": "773-881-3911",
            "fax_number": "773-881-4058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHOOL HOUSE DENTAL SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-22",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JERROLD",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-881-3911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019016584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101412",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lyn Scholomite, LCSW
• Constance J Scholp, APRN
• Bernadette Mari Schoneburg, M.D.
• Alvin Jerry Schonfeld, DO
• Hillary L Schoninger, LCSW
• School of the Art Institute of Chicago
• Victoria Irene Schoone, M.S.
• Jennifer Ann Schoonover, M.S. CCC-SLP/L
• Elizabeth Mary Schorsch, RN
• George Schorse

• 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 Jul 22, 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.