NPIMap

Organization Active NPI

Presidential Dental

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1194917013
Registry record updated Jan 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PRESIDENTIAL DENTAL
Practice address
564 W Washington Blvd
Chicago, IL 60661-2509
Phone
(312) 902-3131
NPI assigned
Aug 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2014

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

Authorized official

Name
Dr. Peter A Michalak, DDSNPI 1225256357
Title
Dentist
Phone
(312) 902-3131

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: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

564 W Washington Blvd
Chicago, IL 60661-2509

Mailing address

564 W Washington Blvd
Chicago, IL 60661-2509
Phone (312) 902-3131

National Provider Directory

National Provider Directory

Locations

564 W Washington Blvd
Chicago, IL 60661
Phone (312) 902-3131

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": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390867200000",
    "number": "1194917013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 W WASHINGTON BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606612509",
            "telephone_number": "312-902-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 W WASHINGTON BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606612509",
            "telephone_number": "312-902-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESIDENTIAL DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2014-01-28",
        "status": "A",
        "authorized_official_last_name": "MICHALAK",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "312-902-3131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "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 Jan 28, 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.