NPIMap

Organization Active NPI

Zavala Dentistry PC

  • Dentist
  • Cicero, IL
National Provider Identifier
1396132890
Registry record updated Apr 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019027256 Issued in IL
Legal business name
ZAVALA DENTISTRY PC
Practice address
4939 W 14TH St
Cicero, IL 60804-1419
Phone
(708) 652-1080
NPI assigned
Apr 22, 2015
Last updated
Apr 22, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2015

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

Authorized official

Name
Dr. Jesse Zavala, DDS
Title
Dentist
Phone
(815) 534-0563

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019027256 IL Primary

Addresses

Primary practice location

4939 W 14TH St
Cicero, IL 60804-1419

Mailing address

4939 W 14TH St
Cicero, IL 60804-1419
Phone (708) 652-1080

National Provider Directory

National Provider Directory

Locations

4939 W 14th St
Cicero, IL 60804
Phone (708) 652-1080

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429660800000",
    "number": "1396132890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4939 W 14TH ST",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608041419",
            "telephone_number": "708-652-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4939 W 14TH ST",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608041419",
            "telephone_number": "708-652-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZAVALA DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-22",
        "last_updated": "2015-04-22",
        "status": "A",
        "authorized_official_last_name": "ZAVALA",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "815-534-0563",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cicero, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; 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.