NPIMap

Organization Active NPI

Dhccltd

  • Dentist
  • Bolingbrook, IL
National Provider Identifier
1174916233
Registry record updated Mar 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019028978 Issued in IL
Legal business name
DHCCLTD
Practice address
319 N Weber Rd
397
Bolingbrook, IL 60490-1569
Phone
(773) 656-3170
NPI assigned
Mar 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2015

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

Authorized official

Name
Dr. Mohamed Waheed
Title
Dentist
Phone
(773) 656-3170

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019028978 IL Primary

Addresses

Primary practice location

319 N Weber Rd
397
Bolingbrook, IL 60490-1569

Mailing address

319 N Weber Rd
397
Bolingbrook, IL 60490-1569

Other identifiers 1

IdentifierTypeStateIssuer
019028978MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Dhccltd2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

319 N Weber Rd
#397
Bolingbrook, IL 60490
Phone (773) 656-3170

NPI Registry JSON

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

{
    "created_epoch": "1426204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426204800000",
    "number": "1174916233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 N WEBER RD",
            "address_2": "397",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604901569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 N WEBER RD",
            "address_2": "397",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604901569",
            "telephone_number": "773-656-3170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DHCCLTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-13",
        "last_updated": "2015-03-13",
        "status": "A",
        "authorized_official_last_name": "WAHEED",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "773-656-3170",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019028978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019028978",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2015; 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.