NPIMap

Organization Active NPI

Innovative Endodontics, P.C.

  • Endodontics
  • Chicago, IL
National Provider Identifier
1508035619
Registry record updated Feb 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
INNOVATIVE ENDODONTICS, P.C.
Practice address
4346 N Pulaski Rd # Ab
Chicago, IL 60641-2156
Phone
(773) 544-1025
Fax
(773) 649-9282
NPI assigned
Feb 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2008

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

Authorized official

Name
Dr. Rebecca S Prescott, DDS, MS
Title
Owner
Phone
(773) 544-1025

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X IL Primary

Addresses

Primary practice location

4346 N Pulaski Rd # Ab
Chicago, IL 60641-2156

Mailing address

4346 N Pulaski Rd # Ab
Chicago, IL 60641-2156

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203638400000",
    "number": "1508035619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4346 N PULASKI RD # AB",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4346 N PULASKI RD # AB",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412156",
            "telephone_number": "773-544-1025",
            "fax_number": "773-649-9282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE ENDODONTICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-22",
        "last_updated": "2008-02-22",
        "status": "A",
        "authorized_official_last_name": "PRESCOTT",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-544-1025",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": null,
            "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 Feb 22, 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.