Brite Dental 59 Pulaski, P.C

Primary specialty

DentistTaxonomy code 122300000X

License

019.026128 Issued in IL

Legal business name

BRITE DENTAL 59 PULASKI, P.C

Practice address

5917 South Pulaski Road
Chicago, IL 60629

Phone

(773) 776-5277

NPI assigned

Nov 5, 2012

Last updated

Nov 5, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Fadi M Aqel, DDS

Title

President

Phone

(708) 439-4655

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, and the practitioner matching its NPPES authorized official.

• Tony Portelles, DMD

  • General Practice Dentistry
  • Houston, TX
  • NPI 1023707387
  NPD (past)

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

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352073600000",
    "number": "1245584853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5917 S PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606294515",
            "telephone_number": "773-735-8469",
            "fax_number": "773-735-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5917 SOUTH PULASKI ROAD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60629",
            "telephone_number": "773-776-5277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRITE DENTAL 59 PULASKI, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-05",
        "last_updated": "2012-11-05",
        "status": "A",
        "authorized_official_last_name": "AQEL",
        "authorized_official_first_name": "FADI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-439-4655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.026128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Chicago, IL
• Providers in Chicago, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; 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.