Perfect Smile Dental Spa

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019028256 Issued in IL

Legal business name

PERFECT SMILE DENTAL SPA

Practice address

2155 W Roscoe St Ste 1N
Chicago, IL 60618-6261

Phone

(773) 528-3384

NPI assigned

Sep 1, 2016

Last updated

Sep 1, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christen Dinkha

Title

President

Phone

(773) 528-3384

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472688000000",
    "number": "1548717093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 W ROSCOE ST STE 1N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186261",
            "telephone_number": "773-528-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 W ROSCOE ST STE 1N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186261",
            "telephone_number": "773-528-3384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFECT SMILE DENTAL SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A",
        "authorized_official_last_name": "DINKHA",
        "authorized_official_first_name": "CHRISTEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-528-3384"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019028256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walter Daniel Perez, MD
• Yesenia Nichole Perez, LPC, NCC
• Perfect Dental Smile, LTD.
• Perfect Managed Care LLC
• Perfect Mile Carrier LLC
• Perfect Smile Dental Spa Partnership
• Perfect Smile Dentistry
• Perfect Smile P. C.
• Perfect Smile P.C. (Montrose Ashland Dental Center)
• Perfect Smile P.C. (Montrose Ashland Dental Center)

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.