NPIMap

Organization Active NPI

Premier Dentistry at Millennium Park LLC

  • Prosthodontics
  • Chicago, IL
National Provider Identifier
1104541622
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
Legal business name
PREMIER DENTISTRY AT MILLENNIUM PARK LLC
Practice address
30 N Michigan Ave
Suite 1503
Chicago, IL 60602
Phone
(312) 726-1901
Fax
(312) 377-5053
NPI assigned
Oct 6, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Authorized official

Name
Dr. Nechama BrandNPI 1184861486
Title
Partner
Phone
(312) 726-1901

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X Primary

Addresses

Primary practice location

30 N Michigan Ave
Suite 1503
Chicago, IL 60602

Mailing address

30 N Michigan Ave
Suite 1503
Chicago, IL 60602
Phone (312) 726-1901

National Provider Directory

National Provider Directory

Locations

30 N Michigan Ave
Ste 1503
Chicago, IL 60602
Phone (312) 726-1901

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665014400000",
    "number": "1104541622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE",
            "address_2": "SUITE 1503",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60602",
            "telephone_number": "312-726-1901",
            "fax_number": "312-377-5053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE",
            "address_2": "SUITE 1503",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60602",
            "telephone_number": "312-726-1901",
            "fax_number": "312-377-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DENTISTRY AT MILLENNIUM PARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-06",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A",
        "authorized_official_last_name": "BRAND",
        "authorized_official_first_name": "NECHAMA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "312-726-1901",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "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 Oct 6, 2022; 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.