Old Orchard Dental Group P.C.

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

OLD ORCHARD DENTAL GROUP P.C.

Practice address

9631 Gross Point Rd
Suite 4
Skokie, IL 60076-1264

Phone

(312) 402-7414

NPI assigned

Mar 9, 2010

Organization subpart

No

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

Authorized official

Name

Atosa Sarrafi, DMD

Title

President

Phone

(312) 402-7414

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268092800000",
    "number": "1578886206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9631 GROSS POINT RD",
            "address_2": "SUITE 4",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9631 GROSS POINT RD",
            "address_2": "SUITE 4",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761264",
            "telephone_number": "312-402-7414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD ORCHARD DENTAL GROUP P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-09",
        "last_updated": "2010-03-09",
        "status": "A",
        "authorized_official_last_name": "SARRAFI",
        "authorized_official_first_name": "ATOSA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-402-7414",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Lynn Okamoto, DDS
• Kristina Okamura, MA
• Busala Oke, MD
• Jodi Novick Okner, LCSW
• Makanjuola Olabiyi
• Old Orchard Endodontics
• Old Orchard Health Medical and Rehab Ctr LTD
• Old Orchard Obstetrics&Gynecology, S.C.
• Old Orchard Periodontics & Implant Dentistry LTD
• Lisa Oldson, M.D.

• Preferred Provider Organization in Skokie, IL
• Providers in Skokie, IL by specialty
• Preferred Provider Organization in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2010; 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.