NPIMap

Organization Active NPI

Chicago Dental Professionals Inc

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chicago, IL
National Provider Identifier
1205841996
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
021000831 Issued in IL
Legal business name
CHICAGO DENTAL PROFESSIONALS INC
Practice address
2340 N Clybourn
Chicago, IL 60614
Phone
(773) 528-2205
Fax
(773) 528-2216
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2011

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

Authorized official

Name
Andrew T Weiss, DDS MSNPI 1306012596
Title
President
Phone
(773) 528-2205

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 6

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 019020453 IL
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 019014591 IL
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 019017259 IL
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 021000499 IL
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 019028564 IL
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 021000831 IL Primary

Addresses

Primary practice location

2340 N Clybourn
Chicago, IL 60614

Mailing address

2340 N Clybourn
Chicago, IL 60614
Phone (773) 528-2205

National Provider Directory

National Provider Directory

Locations

2340 N Clybourn Ave
Chicago, IL 60614
Phone (773) 384-3500

Practitioners & affiliated clinicians

Practitioners 5

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": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325116800000",
    "number": "1205841996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 N CLYBOURN",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60614",
            "telephone_number": "773-528-2205",
            "fax_number": "773-528-2216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 N CLYBOURN",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60614",
            "telephone_number": "773-528-2205",
            "fax_number": "773-528-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO DENTAL PROFESSIONALS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2011-12-29",
        "status": "A",
        "authorized_official_last_name": "WEISS",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-528-2205",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019020453",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019014591",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019017259",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "021000499",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "019028564",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "021000831",
            "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 Dec 29, 2011; 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.