Milwaukee Dental Clinic, Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019017511 Issued in IL

Legal business name

MILWAUKEE DENTAL CLINIC, INC

Practice address

4254 N Milwaukee Ave
Chicago, IL 60641-1643

Phone

(773) 282-7906

Fax

(773) 427-2740

NPI assigned

Nov 20, 2014

Organization subpart

No

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

Authorized official

Name

Imad Bahrani, DDSNPI 1205907599

Title

Owner/Doctor

Phone

(773) 282-7906

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.

• Imad Bahrani, DDS

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1205907599
  NPD (past) Authorized official

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

{
    "created_epoch": "1416441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416441600000",
    "number": "1407253339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4254 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411643",
            "telephone_number": "773-282-7906",
            "fax_number": "773-427-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4254 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411643",
            "telephone_number": "773-282-7906",
            "fax_number": "773-427-2740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILWAUKEE DENTAL CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-20",
        "last_updated": "2014-11-20",
        "status": "A",
        "authorized_official_last_name": "BAHRANI",
        "authorized_official_first_name": "IMAD",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "773-282-7906",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019017511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bozena Miltko
• Milton H Daugherty MD LTD
• Jacqueline Ann Milton
• Nicola C Milton, LCSW
• Nina C Milunas, RD LDN
• Mahmoud Mima
• Denise D. Mimbela
• Mimir Consulting PLLC
• Celia Yvonne Mimms, DDS
• Katja Aisha Mimms, LCPC

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, 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 Nov 20, 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.