Active NPI
Marian Brinker, D.D.S.
- Dentist
- Chgo, IL
National Provider Identifier
1285969428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019-023212
- Practice address
- 11606 S. Western Ave.
Chgo, IL 60643 - Phone
- (773) 233-0155
- Fax
- (773) 233-9941
- NPI assigned
- Oct 6, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019-023212 | IL | Primary |
Addresses
Primary practice location
11606 S. Western Ave.
Chgo, IL 60643
Mailing address
11606 S. Western Ave.
Chgo, IL 60643
Phone (773) 233-0155
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019-023212 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Care Gentle Dental Ctr, P.C. | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Chicago, IL
- NPI 1609990860
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254787200000",
"number": "1285969428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11606 S. WESTERN AVE.",
"city": "CHGO",
"state": "IL",
"postal_code": "60643",
"telephone_number": "773-233-0155",
"fax_number": "773-233-9941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11606 S. WESTERN AVE.",
"city": "CHGO",
"state": "IL",
"postal_code": "60643",
"telephone_number": "773-233-0155",
"fax_number": "773-233-9941"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRINKER",
"first_name": "MARIAN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-06",
"last_updated": "2009-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019-023212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chgo, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.