NPIMap

Organization Active NPI

Oral Healthcare Professionals

  • General Practice Dentistry
  • Downers Grove, IL
National Provider Identifier
1134437262
Registry record updated Sep 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019026703 Issued in IL
Legal business name
ORAL HEALTHCARE PROFESSIONALS
Practice address
2033 Ogden Ave
Downers Grove, IL 60515-2601
Phone
(630) 963-6750
Fax
(630) 963-6761
NPI assigned
Sep 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2010

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

Authorized official

Name
Dr. Eric G. Jackson, D.D.S.NPI 1104949171
Title
Owner
Phone
(630) 963-6750

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019026703 IL Primary

Addresses

Primary practice location

2033 Ogden Ave
Downers Grove, IL 60515-2601

Mailing address

2033 Ogden Ave
Downers Grove, IL 60515-2601
Phone (630) 963-6750

National Provider Directory

National Provider Directory

Locations

2033 Ogden Ave
Downers Grove, IL 60515
Phone (630) 963-6750

Practitioners & affiliated clinicians

Practitioners 3

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": "1285200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285200000000",
    "number": "1134437262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2033 OGDEN AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152601",
            "telephone_number": "630-963-6750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2033 OGDEN AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152601",
            "telephone_number": "630-963-6750",
            "fax_number": "630-963-6761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL HEALTHCARE PROFESSIONALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-23",
        "last_updated": "2010-09-23",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-963-6750",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019026703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.