NPIMap

Organization Active NPI

Southwest Smiling Dental P.C.

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1447816616
Registry record updated May 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SOUTHWEST SMILING DENTAL P.C.
Practice address
11141 S Kedzie Ave
Chicago, IL 60655-2329
Phone
(773) 779-1606
NPI assigned
May 14, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2019

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

Authorized official

Name
Jianjun HaoNPI 1518204023
Title
Owner
Phone
(773) 941-1010

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X
Dental HygienistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 124Q00000X
Dental AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 126800000X

Addresses

Primary practice location

11141 S Kedzie Ave
Chicago, IL 60655-2329

Mailing address

836 S Miller St
Chicago, IL 60607-4207
Phone (773) 941-1010

National Provider Directory

National Provider Directory

Locations

11141 S Kedzie Ave
Chicago, IL 60655
Phone (773) 779-1606

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557792000000",
    "number": "1447816616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 S MILLER ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074207",
            "telephone_number": "773-941-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11141 S KEDZIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606552329",
            "telephone_number": "773-779-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST SMILING DENTAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-14",
        "last_updated": "2019-05-14",
        "status": "A",
        "authorized_official_last_name": "HAO",
        "authorized_official_first_name": "JIANJUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-941-1010"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dental Assistant",
            "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 May 14, 2019; 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.