Rockford Family Dental P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ROCKFORD FAMILY DENTAL P.C.

Practice address

2715 N Main St
Rockford, IL 61103-3111

Phone

(815) 964-8713

Fax

(815) 964-3719

NPI assigned

Jan 16, 2013

Last updated

May 14, 2014By 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. Razvan Cornel Mirza, DDSNPI 1346202918

Title

Secretary/Treasurer

Phone

(815) 964-8713

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Razvan Cornel Mirza, D.D.S.

  • General Practice Dentistry
  • Rockford, IL
  • NPI 1346202918
  NPD (past) Authorized official
• Catherine M Baer-Mirza, D.D.S.

  • General Practice Dentistry
  • Rockford, IL
  • NPI 1134181779
  NPD (past)

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

{
    "created_epoch": "1358294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400025600000",
    "number": "1386982940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 N MAIN ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611033111",
            "telephone_number": "815-964-8713",
            "fax_number": "815-964-3719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2715 N MAIN ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611033111",
            "telephone_number": "815-964-8713",
            "fax_number": "815-964-3719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKFORD FAMILY DENTAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-16",
        "last_updated": "2014-05-14",
        "status": "A",
        "authorized_official_last_name": "MIRZA",
        "authorized_official_first_name": "RAZVAN",
        "authorized_official_middle_name": "CORNEL",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "815-964-8713",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rockford Chiropractic Neurology and Nutrition Center, LTD.
• Rockford Dental Care, P.C.
• Rockford Dental Lounge Inc
• Rockford Dermatology SC
• Rockford Emergency Physicians, LLC
• Rockford Family Planning Foundation
• Rockford Gastroenterology Associates, LTD.
• Rockford Gastroenterology Associates, LTD. (Rockford Endoscopy Center)
• Rockford Health Physician
• Rockford Health Physicians

• General Practice Dentistry in Rockford, IL
• Providers in Rockford, 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 May 14, 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.