Total Dental Center Inc.

Primary specialty

DentistTaxonomy code 122300000X

License

019023710 Issued in IL

Legal business name

TOTAL DENTAL CENTER INC.

Practice address

3342 W Irving Park Rd
Chicago, IL 60618-3310

Phone

(773) 463-5757

Fax

(773) 463-2211

NPI assigned

Mar 3, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Oliver V. Van, DDS

Title

President

Phone

(773) 919-5757

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1548430929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3342 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183310",
            "telephone_number": "773-463-5757",
            "fax_number": "773-463-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3342 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183310",
            "telephone_number": "773-463-5757",
            "fax_number": "773-463-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL DENTAL CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-03",
        "last_updated": "2008-03-03",
        "status": "A",
        "authorized_official_last_name": "VAN",
        "authorized_official_first_name": "OLIVER",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-919-5757",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019023710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Chicago, IL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.