Dental 360 Berwyn LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DENTAL 360 BERWYN LLC

Practice address

7039 Roosevelt Rd
Berwyn, IL 60402-1059

Phone

(708) 956-7759

Fax

(708) 637-4297

NPI assigned

Sep 27, 2019

Organization subpart

No

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

Authorized official

Name

Syed Rehman, DMDNPI 1316321722

Title

Dentist

Phone

(708) 956-7759

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Syed Rehman, DMD

  • Dentist
  • Mount Prospect, IL
  • NPI 1316321722

  General Practice

  NPD (past) Authorized official
• Muhammad Taimur Khan, BDS, MPH, MS

  • Dentist
  • Berwyn, IL
  • NPI 1588440564

  Single Specialty

  NPD

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588982400000",
    "number": "1447801741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7039 ROOSEVELT RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604021059",
            "telephone_number": "708-956-7759",
            "fax_number": "708-637-4297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7039 ROOSEVELT RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604021059",
            "telephone_number": "708-956-7759",
            "fax_number": "708-637-4297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL 360 BERWYN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-27",
        "last_updated": "2020-05-09",
        "certification_date": "2020-05-09",
        "status": "A",
        "authorized_official_last_name": "REHMAN",
        "authorized_official_first_name": "SYED",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "708-956-7759",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charito M Delatorre, MD
• Alexander D. Delos Reyes Jr., M.D.
• Denise Pedroza Sandoval LCPC LLC
• Theresa Christine Denk, MNT
• Dennis Michael Wolf, M.D., LTD.
• Dental 360 Pulaski 67 LLC
• Dental Town LTD
• Michelle Der, RD, LDN, CDE
• Mrudula Desai, MD
• Subodh C Desai, MD

• General Practice Dentistry in Berwyn, IL
• Providers in Berwyn, 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 May 9, 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.