Active NPI
Ez Dental
- Dental Laboratory
- Chicago, IL
National Provider Identifier
1104284710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Laboratory
- License
- 019023027
- Legal business name
- EZ DENTAL
- Practice address
- 5621 W.Montrose Avenue
Chicago, IL 60634 - Phone
- (773) 427-1000
- NPI assigned
- Feb 10, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Abdul Majzoub
- Title
- Boss
- Phone
- (773) 583-4455
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Laboratory | 292200000X | 019023027 | IL | Primary |
Addresses
Primary practice location
5621 W.Montrose Avenue
Chicago, IL 60634
Mailing address
5621 W.Montrose Ave
Chicago, IL 60634
Phone (773) 427-1000
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455062400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1455062400000",
"number": "1104284710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5621 W.MONTROSE AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60634",
"telephone_number": "773-427-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5621 W.MONTROSE AVENUE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60634",
"telephone_number": "773-427-1000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EZ DENTAL",
"organizational_subpart": "NO",
"enumeration_date": "2016-02-10",
"last_updated": "2016-02-10",
"status": "A",
"authorized_official_last_name": "MAJZOUB",
"authorized_official_first_name": "ABDUL",
"authorized_official_title_or_position": "BOSS",
"authorized_official_telephone_number": "773-583-4455"
},
"taxonomies": [
{
"code": "292200000X",
"taxonomy_group": "",
"desc": "Dental Laboratory",
"state": "IL",
"license": "019023027",
"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 Feb 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.