NPIMap

Organization Active NPI

The Dental Specialists

  • Oral and Maxillofacial Surgery (Dentist)
  • Homewood, IL
National Provider Identifier
1417183369
Registry record updated Jun 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
021-001569 Issued in IL
Legal business name
THE DENTAL SPECIALISTS
Practice address
18213 Dixie Hwy
Homewood, IL 60430-2205
Phone
(708) 647-9112
NPI assigned
Jun 5, 2009
Last updated
Jun 5, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2009

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

Authorized official

Name
Rajan Sharma
Title
Owner
Phone
(708) 647-9112

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 021-001569 IL
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 021-001569 IL Primary

Addresses

Primary practice location

18213 Dixie Hwy
Homewood, IL 60430-2205

Mailing address

18213 Dixie Hwy
Homewood, IL 60430-2205
Phone (708) 647-9112

National Provider Directory

National Provider Directory
Tax ID family
The Dental Specialists6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244160000000",
    "number": "1417183369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18213 DIXIE HWY",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302205",
            "telephone_number": "708-647-9112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18213 DIXIE HWY",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302205",
            "telephone_number": "708-647-9112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DENTAL SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-05",
        "last_updated": "2009-06-05",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "RAJAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-647-9112"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "021-001569",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "021-001569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2009; 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.