80TH Ave Dental Associates

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019016658 Issued in IL

Legal business name

80TH AVE DENTAL ASSOCIATES

Practice address

16717 80TH Ave
Tinley Park, IL 60477-2361

Phone

(708) 429-3504

Fax

(708) 429-5667

NPI assigned

Nov 7, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Richard A Strauman, DDSNPI 1336305143

Title

President

Phone

(708) 429-3504

Specialties & licenses 1

Addresses

Other identifiers 7

Locations

Practitioners 2

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

• Richard A Strauman, DDS

  • Dentist
  • Tinley Park, IL
  • NPI 1336305143
  NPD (past) Authorized official
• Dawn B Swenson, DDS

  • Dentist
  • Tinley Park, IL
  • NPI 1730345554
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1255400925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16717 80TH AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772361",
            "telephone_number": "708-429-3504",
            "fax_number": "708-429-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16717 80TH AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772361",
            "telephone_number": "708-429-3504",
            "fax_number": "708-429-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "80TH AVE DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "STRAUMAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-429-3504",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019016658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "CBFL1",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "CBAR1",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "CB621",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "CBAL1",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "SP601",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "CBMI1",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "06126",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 1St Choice Home Health Agency, Inc.
• 31St Street Medical Center S.C.
• 3Rd Generation Therapies LLC
• Ibtisam Abdallah, DMD
• Abdol H Azaran MD SC
• Mohammad Abed, RPH
• Tiffany Abercrombie
• Jose A. Abreu, M.D.

• General Practice Dentistry in Tinley Park, IL
• Providers in Tinley Park, 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 Jul 8, 2008; 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.