NPIMap

Organization Active NPI

C G Rammohan DMD PC

  • Dentist
  • Chicago, IL
National Provider Identifier
1316156383
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
C G RAMMOHAN DMD PC
Doing business as
Southtown Dental Center
Practice address
11004 S Halsted St
Chicago, IL 60628
Phone
(773) 785-0606
Fax
(773) 785-6167
NPI assigned
May 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
C G Rammohan, DMD
Title
President
Phone
(773) 785-0606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X IL Primary

Addresses

Primary practice location

11004 S Halsted St
Chicago, IL 60628

Mailing address

11004 S Halsted St
Chicago, IL 60628
Phone (773) 785-0606

Other names 1

  • Southtown Dental Center Doing business as

National Provider Directory

National Provider Directory

Locations

11004 S Halsted St
Chicago, IL 60628
Phone (773) 785-0606

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316156383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11004 S HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60628",
            "telephone_number": "773-785-0606",
            "fax_number": "773-785-6167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11004 S HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60628",
            "telephone_number": "773-785-0606",
            "fax_number": "773-785-6167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C G RAMMOHAN DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAMMOHAN",
        "authorized_official_first_name": "C G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-785-0606",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southtown Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 2020; 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.