DRS. Pearlman, Klenetsky & Simcox Oral & Maxillofacial Surgery, LTD.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

21000970 Issued in IL

Legal business name

DRS. PEARLMAN, KLENETSKY & SIMCOX ORAL & MAXILLOFACIAL SURGERY, LTD.

Practice address

1126 Westgate St
Oak Park, IL 60301-1008

Phone

(708) 383-8851

Fax

(708) 383-6272

NPI assigned

Feb 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Allan D. Klenetsky, D.M.D.

Title

President

Phone

(708) 383-8851

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• DRS. PEARLMAN, KLENETSKY & SIMCOX ORAL & MAXILLOFACIAL SURGERY, LTD. Doing business as

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427846400000",
    "number": "1497894786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 WESTGATE ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011008",
            "telephone_number": "708-383-8851",
            "fax_number": "708-383-6272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 WESTGATE ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011008",
            "telephone_number": "708-383-8851",
            "fax_number": "708-383-6272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. PEARLMAN, KLENETSKY & SIMCOX ORAL & MAXILLOFACIAL SURGERY, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2015-04-01",
        "status": "A",
        "authorized_official_last_name": "KLENETSKY",
        "authorized_official_first_name": "ALLAN",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-383-8851",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "21000970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "215932",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DRS. PEARLMAN, KLENETSKY & SIMCOX ORAL & MAXILLOFACIAL SURGERY, LTD.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2015; 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.