NPIMap

Organization Active NPI

Art of Modern Dentistry, P.C

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1194259705
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019025332 Issued in IL
Legal business name
ART OF MODERN DENTISTRY, P.C
Practice address
3056 N Southport Ave
Chicago, IL 60657-4218
Phone
(773) 935-3600
Fax
(312) 922-1879
NPI assigned
Apr 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Authorized official

Name
Dr. Farideh Nikoo Daftary, D.D.SNPI 1023235249
Title
Owner
Phone
(312) 922-1898

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 019025332 IL Primary

Addresses

Primary practice location

3056 N Southport Ave
Chicago, IL 60657-4218

Mailing address

3056 N Southport Ave
Chicago, IL 60657-4218
Phone (773) 935-3600

National Provider Directory

National Provider Directory
Tax ID family
Art of Modern Dentistry PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

3056 N Southport Ave
Chicago, IL 60657
Phone (773) 935-3600

Practitioners & affiliated clinicians

Practitioners 1

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": "1492646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492646400000",
    "number": "1194259705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3056 N SOUTHPORT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574218",
            "telephone_number": "773-935-3600",
            "fax_number": "312-922-1879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3056 N SOUTHPORT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574218",
            "telephone_number": "773-935-3600",
            "fax_number": "312-922-1879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ART OF MODERN DENTISTRY, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-20",
        "last_updated": "2017-04-20",
        "status": "A",
        "authorized_official_last_name": "DAFTARY",
        "authorized_official_first_name": "FARIDEH",
        "authorized_official_middle_name": "NIKOO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-922-1898",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025332",
            "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 Apr 20, 2017; 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.