Active NPI
Paul Richard Morrison Jr., DDS
- Dentist
- Chicago, IL
National Provider Identifier
1194012773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019028723
- Practice address
- 3332 N Western Ave
Chicago, IL 60618-6213 - Phone
- (773) 327-6500
- NPI assigned
- Jul 5, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019028723 | IL | Primary |
Addresses
Primary practice location
3332 N Western Ave
Chicago, IL 60618-6213
Mailing address
1920 W School St
Apt 2
Chicago, IL 60657-2035
Phone (856) 981-1049
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019028723 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Graceland Prairie Dental | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Des Plaines, IL
- NPI 1134494727
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338336000000",
"number": "1194012773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1920 W SCHOOL ST",
"address_2": "APT 2",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606572035",
"telephone_number": "856-981-1049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3332 N WESTERN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606186213",
"telephone_number": "773-327-6500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORRISON",
"first_name": "PAUL",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-07-05",
"last_updated": "2012-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019028723",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.