NPIMap

Organization Active NPI

East Village Dental Centre

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1578955738
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019016514 Issued in IL
Legal business name
EAST VILLAGE DENTAL CENTRE
Practice address
901 N Ashland Ave
Chicago, IL 60622-5111
Phone
(773) 278-6622
Fax
(888) 425-2271
NPI assigned
Feb 25, 2015
Last updated
Feb 25, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Authorized official

Name
Mr. Rui J. Barreto
Title
Insurance Coordinator
Phone
(773) 278-6622

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019016514 IL Primary

Addresses

Primary practice location

901 N Ashland Ave
Chicago, IL 60622-5111

Mailing address

901 N Ashland Ave
Chicago, IL 60622-5111
Phone (773) 278-6622

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424822400000",
    "number": "1578955738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225111",
            "telephone_number": "773-278-6622",
            "fax_number": "888-425-2271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225111",
            "telephone_number": "773-278-6622",
            "fax_number": "888-425-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST VILLAGE DENTAL CENTRE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-25",
        "last_updated": "2015-02-25",
        "status": "A",
        "authorized_official_last_name": "BARRETO",
        "authorized_official_first_name": "RUI",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "773-278-6622",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019016514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.