NPIMap

Organization Active NPI

Ora Dental Studio Gold Coast LLC

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1376823658
Registry record updated Aug 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19022824 Issued in IL
Legal business name
ORA DENTAL STUDIO GOLD COAST LLC
Practice address
712 N Dearborn St
Chicago, IL 60654-3818
Phone
(312) 867-8766
Fax
(312) 876-8755
NPI assigned
Aug 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2011

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

Authorized official

Name
Dr. Mladen Kralj, DMD
Title
Owner
Phone
(312) 867-8766

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 19022824 IL Primary

Addresses

Primary practice location

712 N Dearborn St
Chicago, IL 60654-3818

Mailing address

712 N Dearborn St
Chicago, IL 60654-3818
Phone (312) 867-8766

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1313625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313625600000",
    "number": "1376823658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 N DEARBORN ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606543818",
            "telephone_number": "312-867-8766",
            "fax_number": "312-876-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 N DEARBORN ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606543818",
            "telephone_number": "312-867-8766",
            "fax_number": "312-876-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORA DENTAL STUDIO GOLD COAST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-18",
        "last_updated": "2011-08-18",
        "status": "A",
        "authorized_official_last_name": "KRALJ",
        "authorized_official_first_name": "MLADEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-867-8766",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19022824",
            "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 Aug 18, 2011; 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.