NPIMap

Organization Active NPI

Orthodontic Experts

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chicago, IL
National Provider Identifier
1437657582
Registry record updated Jan 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
021002488 Issued in IL
Legal business name
ORTHODONTIC EXPERTS
Practice address
1654 W North Ave
Chicago, IL 60622-2255
Phone
(312) 767-2088
NPI assigned
Jan 24, 2018
Last updated
Jan 21, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
ORTHODONTIC EXPERTS LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 21, 2020

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

Authorized official

Name
Monika Bzdal
Title
Manger
Phone
(773) 801-7171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 021002488 IL Primary

Addresses

Primary practice location

1654 W North Ave
Chicago, IL 60622-2255

Mailing address

1654 W North Ave
Chicago, IL 60622-2255

Other identifiers 1

IdentifierTypeStateIssuer
019028280MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Orthodontic Experts23 organizations share this tax ID, including this one
Part of
Orthodontic Experts

Other organizations with this tax ID 22

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

View all 22

Locations

1654 W North Ave
Chicago, IL 60622
Phone (312) 767-2088

NPI Registry JSON

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

{
    "created_epoch": "1516752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579564800000",
    "number": "1437657582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1654 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1654 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222255",
            "telephone_number": "312-767-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHODONTIC EXPERTS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORTHODONTIC EXPERTS LTD",
        "enumeration_date": "2018-01-24",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A",
        "authorized_official_last_name": "BZDAL",
        "authorized_official_first_name": "MONIKA",
        "authorized_official_title_or_position": "MANGER",
        "authorized_official_telephone_number": "773-801-7171"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "021002488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019028280",
            "state": "IL"
        }
    ],
    "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 Jan 21, 2020; 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.