Jag M Chawla, D.D.S

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

019020214 Issued in IL

Practice address

120 Oakbrook Ctr
Suite 802
Oak Brook, IL 60523-1806

Phone

(630) 571-3030

Fax

(630) 571-1977

NPI assigned

Apr 24, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• West Suburban Family Dental

  • General Practice Dentistry
  • Oak Brook, IL
  • NPI 1689934754

  Orthodontics and Dentofacial Orthopedics

  NPD (past)

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306065073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2S615 AVENUE LATOUR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231064",
            "telephone_number": "630-571-3030",
            "fax_number": "630-515-0786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 OAKBROOK CTR",
            "address_2": "SUITE 802",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231806",
            "telephone_number": "630-571-3030",
            "fax_number": "630-571-1977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAWLA",
        "first_name": "JAG",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019020214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Oak Brook, IL
• Providers in Oak Brook, IL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.