NPIMap

Organization Active NPI

Pulaski Dental Center P.C

Doing business as pulaski dental

  • Dentist
  • Chicago, IL
National Provider Identifier
1467626044
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19024765 Issued in IL
Legal business name
PULASKI DENTAL CENTER P.C
Doing business as
pulaski dental
Practice address
5607 S. Pulaski Road
Chicago, IL 60629
Phone
(773) 585-1980
Fax
(773) 585-1517
NPI assigned
Apr 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2008

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

Authorized official

Name
Dr. Tom Chan, DDSNPI 1407845936
Title
Dentist
Phone
(773) 585-1980

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 19024765 IL Primary

Addresses

Primary practice location

5607 S. Pulaski Road
Chicago, IL 60629

Mailing address

5607 S. Pulaski Road
Chicago, IL 60629
Phone (773) 585-1980

Other names 1

  • pulaski dental Doing business as

National Provider Directory

National Provider Directory

Locations

5607 S Pulaski Rd
Chicago, IL 60629
Phone (773) 585-1980

Practitioners & affiliated clinicians

Practitioners 1

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": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1467626044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5607 S. PULASKI ROAD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60629",
            "telephone_number": "773-585-1980",
            "fax_number": "773-585-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5607 S. PULASKI ROAD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60629",
            "telephone_number": "773-585-1980",
            "fax_number": "773-585-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULASKI DENTAL CENTER P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "773-585-1980",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "19024765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "pulaski dental",
            "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 15, 2008; 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.