NPIMap

Organization Active NPI

Chicago Dental Cosmetics

Doing business as advanced family dental

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1235680109
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019028105 Issued in IL
Legal business name
CHICAGO DENTAL COSMETICS
Doing business as
advanced family dental
Practice address
6338 S Pulaski Rd
Chicago, IL 60629-4706
Phone
(773) 767-1554
NPI assigned
Oct 17, 2016
Organization subpart
Yes
Parent organization
CHICAGO DENTAL COSMETICSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Authorized official

Name
Mustapha Hotait, DDS
Title
President
Phone
(773) 767-1554

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019028105 IL Primary

Addresses

Primary practice location

6338 S Pulaski Rd
Chicago, IL 60629-4706

Mailing address

6338 S Pulaski Rd
Chicago, IL 60629-4706
Phone (773) 767-1554

Other names 1

  • advanced family dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Chicago Dental Cosmetics2 organizations share this tax ID, including this one
Part of
Chicago Dental Cosmetics

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6338 S Pulaski Rd
Chicago, IL 60629
Phone (708) 849-4644

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476662400000",
    "number": "1235680109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6338 S PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606294706",
            "telephone_number": "773-767-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6338 S PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606294706",
            "telephone_number": "773-767-1554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO DENTAL COSMETICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHICAGO DENTAL COSMETICS",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A",
        "authorized_official_last_name": "HOTAIT",
        "authorized_official_first_name": "MUSTAPHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-767-1554",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019028105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "advanced family dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 17, 2016; 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.