Chicago General & Dental Implant Specialists LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

CHICAGO GENERAL & DENTAL IMPLANT SPECIALISTS LLC

Practice address

7407 W Irving Park Rd
Chicago, IL 60634-2139

Phone

(773) 625-2626

Fax

(773) 625-4071

NPI assigned

May 15, 2024

Organization subpart

No

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

Authorized official

Name

Gunjan Jain, DDS

Title

Manager

Phone

(708) 860-1903

Specialties & licenses 2

Addresses

Other names 2

• Apex Oral Surgery and Dental Implant Center Doing business as
• Dentpol Dental Specialist Doing business as

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

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715731200000",
    "number": "1548019235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7407 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606342139",
            "telephone_number": "773-625-2626",
            "fax_number": "773-625-4071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7407 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606342139",
            "telephone_number": "773-625-2626",
            "fax_number": "773-625-4071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO GENERAL & DENTAL IMPLANT SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-15",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A",
        "authorized_official_last_name": "JAIN",
        "authorized_official_first_name": "GUNJAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "708-860-1903",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Apex Oral Surgery and Dental Implant Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dentpol Dental Specialist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in Chicago, IL
• Providers in Chicago, 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 May 15, 2024; 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.