Optimal Dental Lombard PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

OPTIMAL DENTAL LOMBARD PC

Practice address

246 E Janata Blvd
Suite 140
Lombard, IL 60148-5317

Phone

(630) 629-9398

NPI assigned

Oct 7, 2010

Organization subpart

No

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

Authorized official

Name

Ahmed Mataria, DDS

Title

Owner

Phone

(708) 543-0795

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395792000000",
    "number": "1366751489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 E JANATA BLVD",
            "address_2": "SUITE 140",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601485317",
            "telephone_number": "630-629-9398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 E JANATA BLVD",
            "address_2": "SUITE 140",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601485317",
            "telephone_number": "630-629-9398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL DENTAL LOMBARD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-07",
        "last_updated": "2014-03-26",
        "status": "A",
        "authorized_official_last_name": "MATARIA",
        "authorized_official_first_name": "AHMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-543-0795",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; 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.