Suburban Family Dental Center, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019022955 Issued in IL

Legal business name

SUBURBAN FAMILY DENTAL CENTER, INC.

Practice address

5214 N Western Ave
Suite 303
Chicago, IL 60625-2589

Phone

(773) 769-8195

NPI assigned

Feb 28, 2007

Last updated

Apr 15, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Loida Ticzon Preza, D.M.DNPI 1396004164

Title

President

Phone

(773) 769-8195

Specialties & licenses 1

Addresses

Locations

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.

• Loida Ticzon Preza, DMD

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1396004164
  NPD (past) Authorized official

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334448000000",
    "number": "1316074818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5214 N WESTERN AVE",
            "address_2": "SUITE 303",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606252589",
            "telephone_number": "773-769-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5214 N WESTERN AVE",
            "address_2": "SUITE 303",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606252589",
            "telephone_number": "773-769-8195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN FAMILY DENTAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2012-04-15",
        "status": "A",
        "authorized_official_last_name": "PREZA",
        "authorized_official_first_name": "LOIDA",
        "authorized_official_middle_name": "TICZON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-769-8195",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019022955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Siddarth Subramanian
• Tejas Subramanian
• Michael Kirk Subtelny, DMD
• Subtle Shifts Chicago, PLLC
• Suburban Emergency Physicians Group, SC
• Suburban Orthopaedics (Suburban Orthopaedics Ltd)
• Suburban Podiatry Group, PC (Sugar-Free Shoes)
• Succeed Speech Language & Feeding Therapy, LLC
• Sarah Helen Suchko
• Brianna Suchy, CGC

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, 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 Apr 15, 2012; 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.