NPIMap

Organization Active NPI

Athena Dental Institute P C

Doing business as Athena Dental Group of Chicago

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1427580075
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019022059 Issued in IL
Legal business name
ATHENA DENTAL INSTITUTE P C
Doing business as
Athena Dental Group of Chicago
Practice address
1621 W North Ave
Unit C-1
Chicago, IL 60622-2328
Phone
(773) 235-2000
NPI assigned
Apr 3, 2017
Last updated
Apr 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

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

Authorized official

Name
Dr. Andrea Miller-Finch, DDSNPI 1124028113
Title
President
Phone
(773) 235-2000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019022059 IL Primary

Addresses

Primary practice location

1621 W North Ave
Unit C-1
Chicago, IL 60622-2328

Mailing address

1621 W North Ave
Unit C-1
Chicago, IL 60622-2328
Phone (773) 235-2000

Other identifiers 1

IdentifierTypeStateIssuer
1002966MedicaidIL

Other names 1

  • Athena Dental Group of Chicago Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Athena Dental Group of Chicago2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491177600000",
    "number": "1427580075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 W NORTH AVE",
            "address_2": "UNIT C-1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222328",
            "telephone_number": "773-235-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 W NORTH AVE",
            "address_2": "UNIT C-1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222328",
            "telephone_number": "773-235-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENA DENTAL INSTITUTE P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-03",
        "last_updated": "2017-04-03",
        "status": "A",
        "authorized_official_last_name": "MILLER-FINCH",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-235-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019022059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002966",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Athena Dental Group of Chicago",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 3, 2017; 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.