NPIMap

Organization Active NPI

Family Dental Care

  • General Practice Dentistry
  • Tinley Park, IL
National Provider Identifier
1356543755
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FAMILY DENTAL CARE
Practice address
7895 W 159TH St
Tinley Park, IL 60477
Phone
(708) 429-4822
Fax
(708) 429-4873
NPI assigned
Jun 5, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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
Dr. Ghassan Abdallah, DMDNPI 1720179021
Title
DMD Presid
Phone
(708) 429-4822

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X IL Primary

Addresses

Primary practice location

7895 W 159TH St
Tinley Park, IL 60477

Mailing address

7895 W 159TH St
Tinley Park, IL 60477
Phone (708) 429-4822

Other identifiers 1

IdentifierTypeStateIssuer
1001005MedicaidIL

Other names 1

  • Ghassan Abdallah Other name

National Provider Directory

National Provider Directory

Locations

7895 W 159th St
Tinley Park, IL 60477
Phone (312) 429-7373

Practitioners & affiliated clinicians

Practitioners 3

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": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356543755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7895 W 159TH ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "60477",
            "telephone_number": "708-429-4822",
            "fax_number": "708-429-4873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7895 W 159TH ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "60477",
            "telephone_number": "708-429-4822",
            "fax_number": "708-429-4873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ABDALLAH",
        "authorized_official_first_name": "GHASSAN",
        "authorized_official_title_or_position": "DMD PRESID",
        "authorized_official_telephone_number": "708-429-4822",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1001005",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ghassan Abdallah",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tinley Park, 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.