My Dentist, Inc., P.C.

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

MY DENTIST, INC., P.C.

Practice address

97 Paxton Ave
Calumet City, IL 60409-1509

Phone

(708) 868-2888

Fax

(708) 868-2867

NPI assigned

Oct 20, 2005

Organization subpart

No

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

Authorized official

Name

Dr. David Yu, DDSNPI 1316000532

Title

President

Phone

(708) 868-2888

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.

• David Yu, D.D.S.

  • General Practice Dentistry
  • Calumet City, IL
  • NPI 1316000532
  NPD (past) Authorized official

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356330567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 PAXTON AVE",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604091509",
            "telephone_number": "708-868-2888",
            "fax_number": "708-868-2867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 PAXTON AVE",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604091509",
            "telephone_number": "708-868-2888",
            "fax_number": "708-868-2867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY DENTIST, INC., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YU",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-868-2888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Calumet City, IL
• Providers in Calumet City, IL by specialty
• Dentist in Illinois

• 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.