M. Attalla Dental

Primary specialty

DentistTaxonomy code 122300000X

License

01902261 Issued in IL

Legal business name

M. ATTALLA DENTAL

Practice address

2117 E 71St St
Chicago, IL 60649-2103

Phone

(773) 288-0225

Fax

(773) 288-0485

NPI assigned

Sep 24, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Mamdouh M. Attalla, DDS

Title

Owner

Phone

(773) 288-0225

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411516800000",
    "number": "1174925895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 497010",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606490094",
            "telephone_number": "773-288-0225",
            "fax_number": "773-288-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2117 E 71ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606492103",
            "telephone_number": "773-288-0225",
            "fax_number": "773-288-0485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M. ATTALLA DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-24",
        "last_updated": "2014-09-24",
        "status": "A",
        "authorized_official_last_name": "ATTALLA",
        "authorized_official_first_name": "MAMDOUH",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-288-0225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "01902261",
            "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 Sep 24, 2014; 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.