Berwyn Family Dental Center, Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

019-022522 Issued in IL

Legal business name

BERWYN FAMILY DENTAL CENTER, INC

Practice address

7001 W Ogden Avenue
Berwyn, IL 60402-3652

Phone

(708) 749-2419

Fax

(708) 749-2429

NPI assigned

Jan 6, 2009

Last updated

Jan 6, 2009By 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. Cristina Co, D.D.S.NPI 1851537237

Title

President

Phone

(630) 363-4379

Specialties & licenses 1

Addresses

Practitioners 2

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.

• Cristina Co, D.D.S.

  • General Practice Dentistry
  • Berwyn, IL
  • NPI 1851537237
  NPD (past) Authorized official
• Shreya Kota, DMD

  • General Practice Dentistry
  • Berwyn, IL
  • NPI 1942789847
  NPD (past)

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

{
    "created_epoch": "1231200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231200000000",
    "number": "1558507939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7001 W OGDEN AVENUE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023652",
            "telephone_number": "708-749-2419",
            "fax_number": "708-749-2429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7001 W OGDEN AVENUE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023652",
            "telephone_number": "708-749-2419",
            "fax_number": "708-749-2429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERWYN FAMILY DENTAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-06",
        "last_updated": "2009-01-06",
        "status": "A",
        "authorized_official_last_name": "CO",
        "authorized_official_first_name": "CRISTINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-363-4379",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019-022522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Berwyn Dental Inc.
• Berwyn Diagnostic Imaging LLC
• Berwyn Emergency Physicians, LLP
• Berwyn Emergency Services SC (Healthstop)
• Berwyn Family Dental
• Berwyn Foot & Ankle Center
• Berwyn Imaging LLC (Western Open MRI)
• Berwyn Magnetic Resonance Center LLC
• Berwyn Magnetic Resonance Center LLC
• Berwyn Oak Park Family Dentistry

• Dental Clinic/Center in Berwyn, IL
• Providers in Berwyn, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2009; 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.