Ibbi Dental Clinic/Igor Botvinnik

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019025138 Issued in IL

Legal business name

IBBI DENTAL CLINIC/IGOR BOTVINNIK

Practice address

1753 W Chicago Ave
Chicago, IL 60622-5009

Phone

(312) 491-0033

NPI assigned

Oct 22, 2008

Last updated

Oct 22, 2008By 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

Dr. Igot Botvinnik, D.D.S.

Title

President

Phone

(847) 583-0033

Specialties & licenses 1

Addresses

Tax ID family

Ibbi Dental Clinic PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ibbi Dental Clinic PC

  dba Igor Botvinnik DDS

  • General Practice Dentistry
  • Morton Grove, IL
  • NPI 1902941263
  NPD tax ID

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224633600000",
    "number": "1356593206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1753 W CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225009",
            "telephone_number": "312-491-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1753 W CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225009",
            "telephone_number": "312-491-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IBBI DENTAL CLINIC/IGOR BOTVINNIK",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-22",
        "last_updated": "2008-10-22",
        "status": "A",
        "authorized_official_last_name": "BOTVINNIK",
        "authorized_official_first_name": "IGOT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-583-0033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Ibarra
• Carina Ibarra, A.A.S
• Gabriela Ibarra, FNP-BC
• Joshua Ibarra, DO
• Silvia Ibarra
• Eberechukwu O Ibe, MD
• Ijeoma Chinenye Ibe
• Joyce Christina Fortuna Ibe, M.D.
• Taylor Jordan Ibelli, MD
• James R. Iberg, PH.D.

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.