Individual provider Active NPI

Nicholas Alan Flores-Hutton, DMD

  • Dentist
  • Chicago, IL
National Provider Identifier
1205404001
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.033201 Issued in IL
Practice address
3514 N Lincoln Ave
Chicago, IL 60657-1104
Phone
(773) 929-4140
NPI assigned
Jun 16, 2021
Last updated
Aug 31, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.033201 IL Primary

Addresses

Primary practice location

3514 N Lincoln Ave
Chicago, IL 60657-1104

Mailing address

3541 N Lincoln Ave
Chicago, IL 60657-1138
Phone (708) 529-9155

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019.033201ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1205404001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3541 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606571138",
            "telephone_number": "708-529-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3514 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606571104",
            "telephone_number": "773-929-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES-HUTTON",
        "first_name": "NICHOLAS",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.033201",
            "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 Aug 31, 2021; 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.