NPIMap

Organization Active NPI

Midwest Family Dental, LLC

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1497027015
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019025589 Issued in IL
Legal business name
MIDWEST FAMILY DENTAL, LLC
Practice address
2843 W Irving Park Rd
Chicago, IL 60618-3624
Phone
(773) 267-8600
NPI assigned
Jan 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

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

Authorized official

Name
Dr. Randy Chang, DDSNPI 1013913342
Title
Member
Phone
(773) 267-8600

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019025589 IL Primary

Addresses

Primary practice location

2843 W Irving Park Rd
Chicago, IL 60618-3624

Mailing address

2843 W Irving Park Rd
Chicago, IL 60618-3624

National Provider Directory

National Provider Directory
Tax ID family
Midwest Family Dental LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2843 W Irving Park Rd
Chicago, IL 60618
Phone (773) 267-8600

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": "1327622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412121600000",
    "number": "1497027015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2843 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2843 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183624",
            "telephone_number": "773-267-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST FAMILY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-27",
        "last_updated": "2014-10-01",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "773-267-8600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025589",
            "primary": true
        }
    ],
    "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 Oct 1, 2014; 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.