Jenin Dental Corp.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

JENIN DENTAL CORP.

Practice address

3939 W Fullerton Ave
Chicago, IL 60647-2243

Phone

(773) 235-0000

NPI assigned

Jul 21, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Ahmed Massad, DDSNPI 1518533553

Title

Doctor

Phone

(708) 916-2406

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ahmed Massad

  • Dentist
  • Chicago, IL
  • NPI 1518533553
  NPD Authorized official

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626825600000",
    "number": "1235702994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N LAKE SHORE DR APT 3804",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115157",
            "telephone_number": "708-916-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472243",
            "telephone_number": "773-235-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENIN DENTAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A",
        "authorized_official_last_name": "MASSAD",
        "authorized_official_first_name": "AHMED",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "708-916-2406",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jencare Neighborhood Medical Center South Chicago, LLC
• Michael Francis Jendusa, MD
• Roberta Helen Clarke Jenero, LDN
• Alyssa Chrystine Jeng
• Iu-Luen Jeng, LCPC, ATR
• Natasha Tamika Jenkins Cooper, M.D.
• Sharon E. Jenkins-Collins, D.C.
• Adam Jenkins, PT, DPT
• Alexis Jenkins, LCPC, M.ED., NCC
• Andrea Jenell Jenkins

• Dental Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.