NPIMap

Organization Active NPI

Alsahlani and Albazzaz Dental

  • Dentist
  • Waukegan, IL
National Provider Identifier
1184798639
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
ALSAHLANI AND ALBAZZAZ DENTAL
Practice address
1320 Golf Road
Waukegan, IL 60087-4831
Phone
(847) 336-2800
Fax
(847) 662-0163
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Authorized official

Name
Dr. Abdul Monim Albazzaz, DMD
Title
Dentist and Vice President
Phone
(847) 336-2800

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X

Addresses

Primary practice location

1320 Golf Road
Waukegan, IL 60087-4831

Mailing address

1320 Golf Road
Waukegan, IL 60087-4831
Phone (847) 336-2800

Other names 1

  • Thomas G.Bleck DDS and Emam J. Alsahlani DMD, LTD Former legal business name

National Provider Directory

National Provider Directory

Locations

1320 Golf Rd
Waukegan, IL 60087
Phone (847) 336-2800

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691107200000",
    "number": "1184798639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 GOLF ROAD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600874831",
            "telephone_number": "847-336-2800",
            "fax_number": "847-662-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 GOLF ROAD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600874831",
            "telephone_number": "847-336-2800",
            "fax_number": "847-662-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALSAHLANI AND ALBAZZAZ DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A",
        "authorized_official_last_name": "ALBAZZAZ",
        "authorized_official_first_name": "ABDUL",
        "authorized_official_middle_name": "MONIM",
        "authorized_official_title_or_position": "DENTIST AND VICE PRESIDENT",
        "authorized_official_telephone_number": "847-336-2800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thomas G.Bleck DDS and Emam J. Alsahlani DMD, LTD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Waukegan, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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.