Advanced Imaging Studio, Inc.

Primary specialty

DentistTaxonomy code 122300000X

License

319012418 Issued in IL

Legal business name

ADVANCED IMAGING STUDIO, INC.

Doing business as

Ais

Practice address

4307 N Central Ave
Chicago, IL 60634-1815

Phone

(773) 283-3232

Fax

(772) 283-3205

NPI assigned

Nov 16, 2010

Last updated

Nov 16, 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

Mr. Eros Santos

Title

General Manager

Phone

(773) 283-3232

Specialties & licenses 1

Addresses

Other names 1

• AIS Doing business as

Locations

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289865600000",
    "number": "1164723565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4307 N CENTRAL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606341815",
            "telephone_number": "773-283-3232",
            "fax_number": "772-283-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4307 N CENTRAL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606341815",
            "telephone_number": "773-283-3232",
            "fax_number": "772-283-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED IMAGING STUDIO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-16",
        "last_updated": "2010-11-16",
        "status": "A",
        "authorized_official_last_name": "SANTOS",
        "authorized_official_first_name": "EROS",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "773-283-3232",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "319012418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AIS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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