Family Smiles P.C.

Primary specialty

DentistTaxonomy code 122300000X

License

019022805 Issued in IL

Legal business name

FAMILY SMILES P.C.

Practice address

5240 N Pulaski Rd
Suite I
Chicago, IL 60630-1750

Phone

(773) 866-0041

Fax

(773) 866-0045

NPI assigned

May 23, 2007

Organization subpart

No

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

Authorized official

Name

Ali Nematollahi, D.D.S.

Title

Vice-President

Phone

(773) 866-0041

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249344000000",
    "number": "1508076274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5240 N PULASKI RD",
            "address_2": "SUITE I",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606301750",
            "telephone_number": "773-866-0041",
            "fax_number": "773-866-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5240 N PULASKI RD",
            "address_2": "SUITE I",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606301750",
            "telephone_number": "773-866-0041",
            "fax_number": "773-866-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SMILES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2009-08-04",
        "status": "A",
        "authorized_official_last_name": "NEMATOLLAHI",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "773-866-0041",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019022805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Chicago, IL
• Providers in Chicago, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.