NPIMap

Organization Active NPI

Perfect Smile Dental Spa Partnership

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1346486289
Registry record updated Dec 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019020240 Issued in IL
Legal business name
PERFECT SMILE DENTAL SPA PARTNERSHIP
Practice address
2155 W. Roscoe Street, 1N
Chicago, IL 60618-6261
Phone
(773) 528-3384
Fax
(773) 528-3604
NPI assigned
Dec 24, 2008
Last updated
Dec 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2008

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

Authorized official

Name
Dr. Timothy B Dotson, DDSNPI 1669692505
Title
Dentist/Partner
Phone
(773) 528-3384

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 019020240 IL Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 019025986 IL

Addresses

Primary practice location

2155 W. Roscoe Street, 1N
Chicago, IL 60618-6261

Mailing address

2155 W. Roscoe Street, 1N
Chicago, IL 60618-6261
Phone (773) 528-3384

National Provider Directory

National Provider Directory

Locations

2155 W Roscoe St
Ste 1N
Chicago, IL 60618
Phone (773) 528-3384

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1230076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230076800000",
    "number": "1346486289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 W. ROSCOE STREET, 1N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186261",
            "telephone_number": "773-528-3384",
            "fax_number": "773-528-3604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 W. ROSCOE STREET, 1N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186261",
            "telephone_number": "773-528-3384",
            "fax_number": "773-528-3604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFECT SMILE DENTAL SPA PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-24",
        "last_updated": "2008-12-24",
        "status": "A",
        "authorized_official_last_name": "DOTSON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DENTIST/PARTNER",
        "authorized_official_telephone_number": "773-528-3384",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019020240",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025986",
            "primary": false
        }
    ],
    "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 Dec 24, 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.