Active NPI
Toothtown PLLC
Doing business as Toothtown Dental Addison
- Dental Clinic/Center
- Addison, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Clinic/Center
- Legal business name
- TOOTHTOWN PLLC
- Doing business as
- Toothtown Dental Addison
- Practice address
- 303 W Lake St Ste 300
Addison, IL 60101-2564 - Phone
- (630) 352-1547
- NPI assigned
- Jul 15, 2022
- Last updated
- Jul 15, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Yusuf Fahmy, DMD
- Title
- Owner
- Phone
- (630) 352-1547
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | NU | Primary |
Addresses
Primary practice location
303 W Lake St Ste 300
Addison, IL 60101-2564
Mailing address
1042 N Yale Ave
Villa Park, IL 60181-1146
Phone (630) 352-1547
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019030794 | Medicaid | IL |
Other names 1
- Toothtown Dental Addison
National Provider Directory
National Provider Directory- Tax ID family
- Toothtown Dental Addison
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Dental Clinic/Center
- Orland Park, IL
- NPI 1013654037
Locations
303 W Lake St
Ste 300
Addison, IL 60101
Phone (630) 352-1547
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Dentistry
- Hammond, IN
- NPI 1437501723
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657843200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1657843200000",
"number": "1508590415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1042 N YALE AVE",
"city": "VILLA PARK",
"state": "IL",
"postal_code": "601811146",
"telephone_number": "630-352-1547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 W LAKE ST STE 300",
"city": "ADDISON",
"state": "IL",
"postal_code": "601012564",
"telephone_number": "630-352-1547"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TOOTHTOWN PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-07-15",
"last_updated": "2022-07-15",
"certification_date": "2022-07-15",
"status": "A",
"authorized_official_last_name": "FAHMY",
"authorized_official_first_name": "YUSUF",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "630-352-1547",
"authorized_official_credential": "DMD"
},
"taxonomies": [
{
"code": "261QD0000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Dental",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "019030794",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Toothtown Dental Addison",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Addison, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.