NPIMap

Organization Active NPI

Emery Dental Center, P.C.

  • Dentist
  • Mount Prospect, IL
National Provider Identifier
1255636718
Registry record updated Jan 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019027741 Issued in IL
Legal business name
EMERY DENTAL CENTER, P.C.
Practice address
2380 S Elmhurst Rd
Mount Prospect, IL 60056-5805
Phone
(847) 228-5557
Fax
(847) 228-6526
NPI assigned
Jan 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2011

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

Authorized official

Name
Dr. Fawad J Shah, DMD
Title
Owner
Phone
(847) 228-5557

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019027741 IL Primary

Addresses

Primary practice location

2380 S Elmhurst Rd
Mount Prospect, IL 60056-5805

Mailing address

2380 S Elmhurst Rd
Mount Prospect, IL 60056-5805
Phone (847) 228-5557

National Provider Directory

National Provider Directory

Locations

2380 S Elmhurst Rd
Mt Prospect, IL 60056
Phone (847) 228-5557

NPI Registry JSON

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

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294876800000",
    "number": "1255636718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2380 S ELMHURST RD",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600565805",
            "telephone_number": "847-228-5557",
            "fax_number": "847-228-6526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2380 S ELMHURST RD",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600565805",
            "telephone_number": "847-228-5557",
            "fax_number": "847-228-6526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERY DENTAL CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-13",
        "last_updated": "2011-01-13",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "FAWAD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-228-5557",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Prospect, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; 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.