34TH Street Dental Care

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019023728 Issued in IL

Legal business name

34TH STREET DENTAL CARE

Doing business as

34th street dental care

Practice address

6411 34TH St
Berwyn, IL 60402-3717

Phone

(708) 484-6576

Fax

(708) 484-0843

NPI assigned

Jan 7, 2010

Last updated

Jan 7, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Anthony A Brucci, DMD

Title

Owner

Phone

(708) 484-6576

Specialties & licenses 1

Addresses

Other names 1

• 34th street dental care Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Martha C. Villasenor, D.D.S.

  • Dentist
  • Berwyn, IL
  • NPI 1831365907

  General Practice

  NPD (past)
• Kelly Megan Macarthur, D.D.S.

  • General Practice Dentistry
  • Ypsilanti, MI
  • NPI 1306925318
  NPD (past)

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

{
    "created_epoch": "1262822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262822400000",
    "number": "1124358551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6411 34TH ST",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023717",
            "telephone_number": "708-484-6576",
            "fax_number": "708-484-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6411 34TH ST",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023717",
            "telephone_number": "708-484-6576",
            "fax_number": "708-484-0843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "34TH STREET DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-07",
        "last_updated": "2010-01-07",
        "status": "A",
        "authorized_official_last_name": "BRUCCI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-484-6576",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019023728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "34th street dental care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 7 Hills Healthcare Center
• Amer Abboud, MD
• Ossama Fouad Abdellatif, MD
• Soulaf Abou Khachfe, MD
• Alison M. Abraham

• General Practice Dentistry in Berwyn, IL
• Providers in Berwyn, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2010; 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.