Wentworth Dental Clinic PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019025756 Issued in IL

Legal business name

WENTWORTH DENTAL CLINIC PC

Practice address

2323 S Wentworth Ave
Suite 202
Chicago, IL 60616-4615

Phone

(312) 225-5500

NPI assigned

Oct 13, 2009

Organization subpart

No

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

Authorized official

Name

Helen Chan

Title

DMD

Phone

(847) 708-1313

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1255392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255392000000",
    "number": "1467787275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 S WENTWORTH AVE",
            "address_2": "SUITE 202",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606164615",
            "telephone_number": "312-225-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 S WENTWORTH AVE",
            "address_2": "SUITE 202",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606164615",
            "telephone_number": "312-225-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WENTWORTH DENTAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-13",
        "last_updated": "2009-10-13",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "HELEN",
        "authorized_official_title_or_position": "DMD",
        "authorized_official_telephone_number": "847-708-1313"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Wennerberg, APN, CNM
• Karissa Joy Wennstrom, OTD, OTR
• Ivy Elizabeth Wenrich, LCSW
• Lauren S Wenrich, RDN
• Holly M Wentland, CNP
• Wentworth Rehabilitation and Health Care Center, Inc.
• Jason Adam Wentworth, PT
• Monica Priscilla Wentworth, M.D
• Lynne Wentz
• Kendra Leigh Wenzel

• 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 Oct 13, 2009; 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.