Riverside Dental Management, Inc

Primary specialty

DentistTaxonomy code 122300000X

License

019022779 Issued in IL

Legal business name

RIVERSIDE DENTAL MANAGEMENT, INC

Doing business as

Denture Service

Practice address

7716 W. 26TH St.
North Riverside, IL 60546-1509

Phone

(708) 447-2266

Fax

(708) 447-2486

NPI assigned

May 14, 2007

Last updated

Mar 24, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jonathan Villanueva

Title

Practice Manager

Phone

(630) 324-6749

Specialties & licenses 2

Addresses

Other names 1

• Denture Service Doing business as

Locations

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.

• Amy Elizabeth Hyttinen, DDS

  • General Practice Dentistry
  • North Riverside, IL
  • NPI 1861562597
  NPD (past)
• Tatiana M Mitrovic, DDS

  • Dentist
  • North Riverside, IL
  • NPI 1144390402
  NPD (past)

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269388800000",
    "number": "1356556146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7716 W. 26TH ST.",
            "city": "NORTH RIVERSIDE",
            "state": "IL",
            "postal_code": "605461509",
            "telephone_number": "708-447-2266",
            "fax_number": "708-447-2486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7716 W. 26TH ST.",
            "city": "NORTH RIVERSIDE",
            "state": "IL",
            "postal_code": "605461509",
            "telephone_number": "708-447-2266",
            "fax_number": "708-447-2486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE DENTAL MANAGEMENT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2010-03-24",
        "status": "A",
        "authorized_official_last_name": "VILLANUEVA",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "630-324-6749"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019022779",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Denture Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pooja Jamnadas Rao, MD
• Radhika Rawal, D.D.S.
• Karen Rhyce
• Alexis Noemi Rivera
• Esperanza Rivera
• Daniela Rodriguez, OTD, OTR/L
• Karla Rodriguez
• Brizanelly Romero
• Nancy M Roudebush, DT
• Rush Oak Park Physicians Group North Riverside

• Dentist in North Riverside, IL
• Providers in North Riverside, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; 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.