Griffin Orthodontics PC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

019025726 Issued in IL

Legal business name

GRIFFIN ORTHODONTICS PC

Doing business as

ivory dental specialist llc

Practice address

1040 E 47TH Street
Chicago, IL 60653

Phone

(773) 239-7696

NPI assigned

Oct 2, 2013

Last updated

Oct 2, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

IVORY DENTAL SPECIALIST LLCAs reported in NPPES

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

Authorized official

Name

Dr. Bonciel Griffin, DDS

Title

Orthodontist/Owner

Phone

(773) 239-7696

Specialties & licenses 2

Addresses

Other names 1

• ivory dental specialist llc Doing business as

Tax ID family

Griffin Orthodontics PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Griffin Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chicago, IL
  • NPI 1659645182
  NPD tax ID
• Griffin Orthodontics PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chicago, IL
  • NPI 1821429804
  NPD tax ID

Locations

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

{
    "created_epoch": "1380672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380672000000",
    "number": "1417384793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 E 47TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606533600",
            "telephone_number": "773-924-5123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 E 47TH STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60653",
            "telephone_number": "773-239-7696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRIFFIN ORTHODONTICS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IVORY DENTAL SPECIALIST LLC",
        "enumeration_date": "2013-10-02",
        "last_updated": "2013-10-02",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "BONCIEL",
        "authorized_official_title_or_position": "ORTHODONTIST/OWNER",
        "authorized_official_telephone_number": "773-239-7696",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "021002361",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019025726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ivory dental specialist llc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Griego
• Jasmine Lashun Grier, LCSW
• Megan Griesel, PSYD
• Emily Griesemer, CRNA
• Griffin Orthodontics
• Griffin Orthodontics PC
• Bonciel Latrice Griffin-Burress, DDS
• Alexander Bradley Griffin, M.D.
• Alison Marie Griffin, MD
• Alizah Griffin

• Orthodontics and Dentofacial Orthopedics Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; 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.