Individual provider Active NPI

Zenobia L Sowell, DDS

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1104086347
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019020309 Issued in IL
Practice address
1122 N Clark St
Suite 1
Chicago, IL 60610-2857
Phone
(312) 944-9355
Fax
(312) 944-7328
NPI assigned
Jun 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019020309 IL Primary

Addresses

Primary practice location

1122 N Clark St
Suite 1
Chicago, IL 60610-2857

Mailing address

1122 N Clark St
Suite 1
Chicago, IL 60610-2857
Phone (312) 944-9355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019020309ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
So-Well Dental Associates,P.C. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1104086347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 N CLARK ST",
            "address_2": "SUITE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102857",
            "telephone_number": "312-944-9355",
            "fax_number": "312-944-7328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 N CLARK ST",
            "address_2": "SUITE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102857",
            "telephone_number": "312-944-9355",
            "fax_number": "312-944-7328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOWELL",
        "first_name": "ZENOBIA",
        "middle_name": "L",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019020309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 11, 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.