Organization Active NPI

Jonelle Urgena DDS PC

Doing business as Oak Forest Dental Wellness

  • Dentist
  • Oak Forest, IL
National Provider Identifier
1366106874
Registry record updated Oct 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
JONELLE URGENA DDS PC
Doing business as
Oak Forest Dental Wellness
Practice address
15028 Cicero Ave Unit Defg
Oak Forest, IL 60452-1438
Phone
(708) 535-0050
Fax
(708) 535-2170
NPI assigned
Oct 30, 2021
Last updated
Oct 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2021

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

Authorized official

Name
Dr. Jonelle Mariah Doctor Urgena, DDS
Title
Dentist/Owner
Phone
(708) 535-0050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

15028 Cicero Ave Unit Defg
Oak Forest, IL 60452-1438

Mailing address

15028 Cicero Ave Unit Defg
Oak Forest, IL 60452-1438
Phone (708) 535-0050

Other names 1

  • Oak Forest Dental Wellness Doing business as

National Provider Directory

National Provider Directory

Locations

15028 Cicero Ave
Unit Defg
Oak Forest, IL 60452
Phone (708) 535-0050

NPI Registry JSON

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

{
    "created_epoch": "1635552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635552000000",
    "number": "1366106874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15028 CICERO AVE UNIT DEFG",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604521438",
            "telephone_number": "708-535-0050",
            "fax_number": "708-535-2170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15028 CICERO AVE UNIT DEFG",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604521438",
            "telephone_number": "708-535-0050",
            "fax_number": "708-535-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONELLE URGENA DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-30",
        "last_updated": "2021-10-30",
        "certification_date": "2021-10-30",
        "status": "A",
        "authorized_official_last_name": "URGENA",
        "authorized_official_first_name": "JONELLE",
        "authorized_official_middle_name": "MARIAH DOCTOR",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "708-535-0050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oak Forest Dental Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oak Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2021; 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.