NPIMap

Organization Active NPI

Burbank Dental

  • Dentist
  • Burbank, IL
National Provider Identifier
1164608592
Registry record updated Jan 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
BURBANK DENTAL
Practice address
4817 W 83Rd St
Burbank, IL 60459-2790
Phone
(708) 423-6114
Fax
(708) 229-0716
NPI assigned
Jan 16, 2008
Last updated
Jan 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2008

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

Authorized official

Name
Dr. Nuha NakibNPI 1326193731
Title
Periodontist
Phone
(708) 432-6114

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary

Addresses

Primary practice location

4817 W 83Rd St
Burbank, IL 60459-2790

Mailing address

4817 W 83Rd St
Burbank, IL 60459-2790
Phone (708) 423-6114

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200441600000",
    "number": "1164608592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4817 W 83RD ST",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604592790",
            "telephone_number": "708-423-6114",
            "fax_number": "708-229-0716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4817 W 83RD ST",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604592790",
            "telephone_number": "708-423-6114",
            "fax_number": "708-229-0716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURBANK DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-16",
        "last_updated": "2008-01-16",
        "status": "A",
        "authorized_official_last_name": "NAKIB",
        "authorized_official_first_name": "NUHA",
        "authorized_official_title_or_position": "PERIODONTIST",
        "authorized_official_telephone_number": "708-432-6114",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; 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.