NPIMap

Organization Active NPI

Noor Obaisi, DDS, PC

  • Dentist
  • Chicago, IL
National Provider Identifier
1336580679
Registry record updated Jul 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019028304 Issued in IL
Legal business name
NOOR OBAISI, DDS, PC
Practice address
3334 W Peterson Ave
Lower Level
Chicago, IL 60659-3505
Phone
(773) 588-9200
NPI assigned
Jul 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2013

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

Authorized official

Name
Dr. Noor Obaisi, DDS, MSNPI 1417392457
Title
President
Phone
(217) 314-0033

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019028304 IL Primary

Addresses

Primary practice location

3334 W Peterson Ave
Lower Level
Chicago, IL 60659-3505

Mailing address

3334 W Peterson Ave
Lower Level
Chicago, IL 60659-3505

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1373846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373846400000",
    "number": "1336580679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 W PETERSON AVE",
            "address_2": "LOWER LEVEL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3334 W PETERSON AVE",
            "address_2": "LOWER LEVEL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593505",
            "telephone_number": "773-588-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOOR OBAISI, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-15",
        "last_updated": "2013-07-15",
        "status": "A",
        "authorized_official_last_name": "OBAISI",
        "authorized_official_first_name": "NOOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-314-0033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019028304",
            "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 Jul 15, 2013; 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.