NPIMap

Organization Active NPI

Archer Dentistry LLC

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1417410127
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ARCHER DENTISTRY LLC
Practice address
3924 S Archer Ave Unit de
Chicago, IL 60632-1116
Phone
(630) 247-7216
NPI assigned
Apr 9, 2019
Last updated
Jul 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Authorized official

Name
Rahul Jadhav
Title
Owner
Phone
(630) 247-7216

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary
Dental Clinic/Center 261QD0000X

Addresses

Primary practice location

3924 S Archer Ave Unit de
Chicago, IL 60632-1116

Mailing address

3924 S Archer Ave Unit D
Chicago, IL 60632-1116
Phone (630) 247-7216

National Provider Directory

National Provider Directory

Locations

3924 S Archer Ave
Unit De
Chicago, IL 60632
Phone (630) 247-7216

NPI Registry JSON

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626048000000",
    "number": "1417410127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3924 S ARCHER AVE UNIT D",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606321116",
            "telephone_number": "630-247-7216",
            "fax_number": "773-787-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3924 S ARCHER AVE UNIT DE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606321116",
            "telephone_number": "630-247-7216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCHER DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-09",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A",
        "authorized_official_last_name": "JADHAV",
        "authorized_official_first_name": "RAHUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-247-7216"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; 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.