NPIMap

Organization Active NPI

Grand Dentistry

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1295145092
Registry record updated May 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019028510 Issued in IL
Legal business name
GRAND DENTISTRY
Practice address
116 W Grand Ave
#1
Chicago, IL 60654-5207
Phone
(312) 955-9020
NPI assigned
May 1, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2014

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

Authorized official

Name
Dr. Deepan Pravin Patel, DNDNPI 1811207871
Title
Dentist
Phone
(616) 443-5097

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019028510 IL Primary

Addresses

Primary practice location

116 W Grand Ave
#1
Chicago, IL 60654-5207

Mailing address

116 W Grand Ave
#1
Chicago, IL 60654-5207
Phone (312) 955-9020

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1398902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398902400000",
    "number": "1295145092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 W GRAND AVE",
            "address_2": "#1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606545207",
            "telephone_number": "312-955-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 W GRAND AVE",
            "address_2": "#1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606545207",
            "telephone_number": "312-955-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-01",
        "last_updated": "2014-05-01",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "DEEPAN",
        "authorized_official_middle_name": "PRAVIN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "616-443-5097",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DND"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019028510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2014; 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.