Gardenia Dental II LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

GARDENIA DENTAL II LLC

Practice address

5352 N Lincoln Ave
Chicago, IL 60625-2316

Phone

(773) 353-5047

Fax

(773) 303-6344

NPI assigned

Oct 18, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Mohammad Khamis, MD

Title

Manager

Phone

(773) 353-5047

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1382054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382054400000",
    "number": "1144658691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5352 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606252316",
            "telephone_number": "773-353-5047",
            "fax_number": "773-303-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5352 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606252316",
            "telephone_number": "773-353-5047",
            "fax_number": "773-303-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDENIA DENTAL II LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-18",
        "last_updated": "2013-10-18",
        "status": "A",
        "authorized_official_last_name": "KHAMIS",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-353-5047",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence Harvey Gard, PH.D.
• Garden Center Servises
• Garden of Reflection
• Garden View Home, Inc. (Garden View Nursing & Rehab Center)
• Jerome Mark Garden, M.D.
• Jessica Glenn Gardiner, M.D.
• John Gardiner, LCPC
• Lynnquell Gardiner
• Mariel Gardiner, LCPC
• Gardner Psychological Associates, Inc.

• Dental Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2013; 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.