Patricia Crisostomo DMD PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019025133 Issued in IL

Legal business name

PATRICIA CRISOSTOMO DMD PC

Practice address

1732 W Lawrence Ave
Chicago, IL 60640-4412

Phone

(773) 271-7910

Fax

(773) 271-7912

NPI assigned

Dec 16, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Patricia Bettina Crisostomo, D.M.D.

Title

Dentist

Phone

(773) 271-7910

Specialties & licenses 1

Addresses

Other names 1

• Lawrence-Ashland Dental Care Doing business as

Locations

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

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257120000000",
    "number": "1235375593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 408080",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606409998",
            "telephone_number": "773-271-7910",
            "fax_number": "773-271-7912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1732 W LAWRENCE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404412",
            "telephone_number": "773-271-7910",
            "fax_number": "773-271-7912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICIA CRISOSTOMO DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-16",
        "last_updated": "2009-11-02",
        "status": "A",
        "authorized_official_last_name": "CRISOSTOMO",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "BETTINA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "773-271-7910",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lawrence-Ashland Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kousiki Patra, MD
• Dimitrios Thomas Patrianakos, MD
• Thomas D Patrianakos, D.O.
• Patricia a McKenna PHD Inc.
• Patricia a Mueller MD PC
• Patricia F. Katz, M.D.
• Patricia Gale, M.D., S.C.
• Patricia Gale, MD, S.C.
• Patricia Gilleran DDS PC
• Patricia Harthun LCPC LTD

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2009; 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.