1St Brite Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

1ST BRITE DENTAL

Practice address

2759 W 55TH St
Chicago, IL 60632

Phone

(773) 776-5277

Fax

(773) 776-5278

NPI assigned

Jan 31, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Fadi M Aqel, DDS

Title

Dentist

Phone

(773) 776-5277

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487791422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2759 W 55TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60632",
            "telephone_number": "773-776-5277",
            "fax_number": "773-776-5278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2759 W 55TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60632",
            "telephone_number": "773-776-5277",
            "fax_number": "773-776-5278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1ST BRITE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AQEL",
        "authorized_official_first_name": "FADI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "773-776-5277",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 22, 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.