Your Family Dentist

Primary specialty

DentistTaxonomy code 122300000X

License

019-023605 Issued in IL

Legal business name

YOUR FAMILY DENTIST

Practice address

8441 W Lawrence Ave
Chicago, IL 60656-2953

Phone

(773) 589-1400

Fax

(773) 589-1408

NPI assigned

Sep 19, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Emad E Azab, D.D.S.NPI 1629247572

Title

President

Phone

(773) 589-1400

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Emad E Azab, D.D.S

  • Dentist
  • Chicago, IL
  • NPI 1629247572
  NPD (past) Authorized official

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

{
    "created_epoch": "1221782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221782400000",
    "number": "1396995999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8441 W LAWRENCE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606562953",
            "telephone_number": "773-589-1400",
            "fax_number": "773-589-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8441 W LAWRENCE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606562953",
            "telephone_number": "773-589-1400",
            "fax_number": "773-589-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR FAMILY DENTIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-19",
        "last_updated": "2008-09-19",
        "status": "A",
        "authorized_official_last_name": "AZAB",
        "authorized_official_first_name": "EMAD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-589-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-023605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1001115",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Chicago, IL
• Providers in Chicago, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.