Park Place Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

License

1917894 Issued in IL

Legal business name

PARK PLACE DENTAL LLC

Practice address

7702 W North Ave
Elmwood Park, IL 60707-4123

Phone

(708) 453-7275

NPI assigned

Jul 8, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Zachary N Soiya, DDS

Title

Owner

Phone

(630) 453-7275

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jamie Ann Korolyov, D.M.D.

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1801271184
  NPD (past)

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1316100514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7702 W NORTH AVE",
            "city": "ELMWOOD PARK",
            "state": "IL",
            "postal_code": "607074123",
            "telephone_number": "708-453-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7702 W NORTH AVE",
            "city": "ELMWOOD PARK",
            "state": "IL",
            "postal_code": "607074123",
            "telephone_number": "708-453-7275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PLACE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-08",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "SOIYA",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-453-7275",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "1917894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1821135823",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Panton Eye Center
• Elizabeth M Panton, O.D.
• Peter Panton, M.D.
• Papa Medical Pharmacy Inc.
• Atheefur Rahman Papa, D.D.S.
• Kyuhun Park
• Fred Henry Pasquesi, D.D.S.
• Deepa Cherla Patel, MD
• Adam Pepek, PHARMD
• Matthew David Phillips, MD

• Dentist in Elmwood Park, IL
• Providers in Elmwood Park, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; 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.