Montrose Family Dental Center

Primary specialty

DentistTaxonomy code 122300000X

License

019022192 Issued in IL

Legal business name

MONTROSE FAMILY DENTAL CENTER

Doing business as

Edward G. Vivit, DDS

Practice address

3338 W Montrose Ave
Chicago, IL 60618-1247

Phone

(773) 478-9393

Fax

(773) 478-9303

NPI assigned

Feb 7, 2007

Last updated

Jun 3, 2015By 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

Dr. Edward G. Vivit, D.D.S.NPI 1174663561

Title

President

Phone

(773) 478-9393

Specialties & licenses 1

Addresses

Other names 1

• Edward G. Vivit, DDS Doing business as

Locations

Practitioners 3

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.

• Edward Geronimo Vivit, DDS

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1174663561
  NPD (past) Authorized official
• Marjorie J Kho, DDS

  • Dentist
  • Chicago, IL
  • NPI 1558679365
  NPD (past)
• Mary Kho Vivit, DDS

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1013057405
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433289600000",
    "number": "1558401844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3338 W MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606181247",
            "telephone_number": "773-478-9393",
            "fax_number": "773-478-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3338 W MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606181247",
            "telephone_number": "773-478-9393",
            "fax_number": "773-478-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTROSE FAMILY DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2015-06-03",
        "status": "A",
        "authorized_official_last_name": "VIVIT",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-478-9393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019022192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edward G. Vivit, DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sonia E Montoya, RDH
• Taryn Rae Montoya, MSPT, PT
• Montrose Dental Clinic PC
• Montrose Dental Clinic PC
• Montrose Dental Group P.C.
• Montrose Foot and Ankle LLC
• Kirstin Montsma
• Priscilla Nwamy Monu, MS,RD,LDN
• Monument Outreach Community Services
• Moody Bible Institute (Moody Theological Seminary Counseling Center)

• 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 Jun 3, 2015; 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.