Organization Active NPI

Hyde Park Dental Profile

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1366613671
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
HYDE PARK DENTAL PROFILE
Practice address
1634 E 53Rd St
Suite 101&102
Chicago, IL 60615-4384
Phone
(773) 752-5677
Fax
(773) 752-6029
NPI assigned
Mar 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

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

Authorized official

Name
Amneh Arnous
Title
D.D.S
Phone
(773) 752-5677

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X IL Primary

Addresses

Primary practice location

1634 E 53Rd St
Suite 101&102
Chicago, IL 60615-4384

Mailing address

1634 E 53Rd St
Suite 101&102
Chicago, IL 60615-4384
Phone (773) 752-5677

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205366400000",
    "number": "1366613671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 E 53RD ST",
            "address_2": "SUITE 101&102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154384",
            "telephone_number": "773-752-5677",
            "fax_number": "773-752-6029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 E 53RD ST",
            "address_2": "SUITE 101&102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154384",
            "telephone_number": "773-752-5677",
            "fax_number": "773-752-6029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYDE PARK DENTAL PROFILE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2008-03-13",
        "status": "A",
        "authorized_official_last_name": "ARNOUS",
        "authorized_official_first_name": "AMNEH",
        "authorized_official_title_or_position": "D.D.S",
        "authorized_official_telephone_number": "773-752-5677"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.