Organization Active NPI

Midwest Dental Associates

  • Preferred Provider Organization
  • Aurora, IL
National Provider Identifier
1356515175
Registry record updated Apr 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
019026586 Issued in IL
Legal business name
MIDWEST DENTAL ASSOCIATES
Practice address
1677 Montgomery Rd
Aurora, IL 60504-8802
Phone
(630) 499-9400
Fax
(630) 499-9494
NPI assigned
Apr 14, 2008
Last updated
Apr 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2008

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

Authorized official

Name
Mrs. Mohammed/ Samaan Salamah/ Samy, DDS
Title
Dentist
Phone
(630) 499-9400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X 019026586 IL Primary

Addresses

Primary practice location

1677 Montgomery Rd
Aurora, IL 60504-8802

Mailing address

1677 Montgomery Rd
Aurora, IL 60504-8802
Phone (630) 499-9400

National Provider Directory

National Provider Directory

Locations

1677 Montgomery Rd
Aurora, IL 60504
Phone (630) 499-9400

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": "1208131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208131200000",
    "number": "1356515175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1677 MONTGOMERY RD",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605048802",
            "telephone_number": "630-499-9400",
            "fax_number": "630-499-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1677 MONTGOMERY RD",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605048802",
            "telephone_number": "630-499-9400",
            "fax_number": "630-499-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-14",
        "last_updated": "2008-04-14",
        "status": "A",
        "authorized_official_last_name": "SALAMAH/ SAMY",
        "authorized_official_first_name": "MOHAMMED/ SAMAAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "630-499-9400",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "IL",
            "license": "019026586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.