Brite Dental Fullerton, P.C.

Primary specialty

DentistTaxonomy code 122300000X

License

019026128 Issued in IL

Legal business name

BRITE DENTAL FULLERTON, P.C.

Practice address

4953 W Fullerton Ave
Chicago, IL 60639-2505

Phone

(773) 887-3244

Fax

(773) 887-3246

NPI assigned

Nov 5, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Fadi M Aqel, DDS

Title

President

Phone

(708) 439-4655

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352073600000",
    "number": "1154675726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4953 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606392505",
            "telephone_number": "773-887-3244",
            "fax_number": "773-887-3246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4953 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606392505",
            "telephone_number": "773-887-3244",
            "fax_number": "773-887-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRITE DENTAL FULLERTON, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-05",
        "last_updated": "2012-11-05",
        "status": "A",
        "authorized_official_last_name": "AQEL",
        "authorized_official_first_name": "FADI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-439-4655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019026128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Chicago, IL
• Providers in Chicago, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; 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.