Active NPI
Perfect Dental Smile, LTD
- Dentist
- Cicero, IL
National Provider Identifier
1194976282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019024872
- Legal business name
- PERFECT DENTAL SMILE, LTD
- Practice address
- 6017 W Cermak Rd
Cicero, IL 60804-2018 - Phone
- (708) 652-8466
- Fax
- (708) 652-8994
- NPI assigned
- Oct 7, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Bushra Ahmed Al Azzawi, D.D.S.
- Title
- Dentist
- Phone
- (773) 561-2808
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019024872 | IL | Primary |
Addresses
Primary practice location
6017 W Cermak Rd
Cicero, IL 60804-2018
Mailing address
6017 W Cermak Rd
Cicero, IL 60804-2018
Phone (708) 652-8466
National Provider Directory
National Provider Directory- Tax ID family
- Perfect Dental Smile LTD
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Dentist
- Chicago, IL
- NPI 1104077692
Locations
6017 W Cermak Rd
Cicero, IL 60804
Phone (708) 652-8466
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Chicago, IL
- NPI 1730220450
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223337600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1223337600000",
"number": "1194976282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6017 W CERMAK RD",
"city": "CICERO",
"state": "IL",
"postal_code": "608042018",
"telephone_number": "708-652-8466",
"fax_number": "708-652-8994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6017 W CERMAK RD",
"city": "CICERO",
"state": "IL",
"postal_code": "608042018",
"telephone_number": "708-652-8466",
"fax_number": "708-652-8994"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PERFECT DENTAL SMILE, LTD",
"organizational_subpart": "NO",
"enumeration_date": "2008-10-07",
"last_updated": "2008-10-07",
"status": "A",
"authorized_official_last_name": "AL AZZAWI",
"authorized_official_first_name": "BUSHRA",
"authorized_official_middle_name": "AHMED",
"authorized_official_title_or_position": "DENTIST",
"authorized_official_telephone_number": "773-561-2808",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.D.S."
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "IL",
"license": "019024872",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cicero, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.