Cusp Dental Studio PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019-026174 Issued in IL

Legal business name

CUSP DENTAL STUDIO PC

Practice address

3917 N Ashland Ave
Chicago, IL 60613-5233

Phone

(773) 687-8052

NPI assigned

Aug 30, 2016

Organization subpart

No

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

Authorized official

Name

Jackie Jones

Title

Manager

Phone

(773) 687-8052

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472515200000",
    "number": "1447706494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3917 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3917 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135233",
            "telephone_number": "773-687-8052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSP DENTAL STUDIO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-30",
        "last_updated": "2016-08-30",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-687-8052"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-026174",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-029332",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-030017",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Xana Cushingberry
• Xia Dae Cushingberry
• Jennifer Cushman, DO
• Jennifer Lee Cushman, LCSW
• Taylor N Cusick, MD
• Emily Custer
• Corazon B Custodio, MD
• Custom Healing and Wellness Ministries, NFP
• Custom Home Care, Inc.
• Custom Med, LLC

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.