North Shore Dental Associates

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019021639 Issued in IL

Legal business name

NORTH SHORE DENTAL ASSOCIATES

Practice address

636 Church St
#322
Evanston, IL 60201-4508

Phone

(847) 475-4544

Fax

(847) 475-4523

NPI assigned

Oct 3, 2012

Last updated

Oct 3, 2012By 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. Stamata Blanas, DDSNPI 1245449503

Title

Owner

Phone

(847) 475-4544

Specialties & licenses 1

Addresses

Locations

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.

• Stamata Blanas, D.D.S.

  • General Practice Dentistry
  • Evanston, IL
  • NPI 1245449503
  NPD (past) Authorized official

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

{
    "created_epoch": "1349222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349222400000",
    "number": "1407108251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 CHURCH ST",
            "address_2": "#322",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014508",
            "telephone_number": "847-475-4544",
            "fax_number": "847-475-4523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 CHURCH ST",
            "address_2": "#322",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014508",
            "telephone_number": "847-475-4544",
            "fax_number": "847-475-4523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-03",
        "last_updated": "2012-10-03",
        "status": "A",
        "authorized_official_last_name": "BLANAS",
        "authorized_official_first_name": "STAMATA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-475-4544",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019021639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nolan K M Chun DDS PC (Evanston Dental Care)
• Robert J. Noone, PH.D
• Christopher Nora, MS, MA, LPC, LCPC
• North Shore Associates in Gynecology and Obstetrics, S.C.
• North Shore Consultants in Nephrology & Hypertension, SC
• North Shore Dentistry for Children
• North Shore Eye Center, Inc.
• North Shore Infusion LTD
• North Shore Pathology Consultants, S.C.
• North Shore Physicians Group, LLC

• General Practice Dentistry in Evanston, IL
• Providers in Evanston, 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 Oct 3, 2012; 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.