Organization Active NPI

Bright Smile Dental Clinic, LTD.

  • Dentist
  • Chicago, IL
National Provider Identifier
1588835755
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
BRIGHT SMILE DENTAL CLINIC, LTD.
Practice address
6027 W Belmont Ave Ste a
Chicago, IL 60634-5116
Phone
(773) 237-4291
Fax
(773) 237-4291
NPI assigned
Mar 17, 2008
Last updated
Mar 17, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
BRIGHT SMILE DENTAL CLINIC, LTD.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Authorized official

Name
Abdulhassan A Tawoosi, DDS
Title
Owner
Phone
(773) 546-8317

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X IL Primary

Addresses

Primary practice location

6027 W Belmont Ave Ste a
Chicago, IL 60634-5116

Mailing address

6027 1/2 W. Belmont Ave
Chicago, IL 60634
Phone (773) 237-4291

Other identifiers 1

IdentifierTypeStateIssuer
1518155191MedicaidIL

National Provider Directory

National Provider Directory
Part of
Bright Smile Dental Clinic LTD

Locations

6027 W Belmont Ave
Chicago, IL 60634
Phone (773) 237-4291

6027 W Belmont Ave
Ste A
Chicago, IL 60634
Phone (773) 237-4291

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1588835755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6027 1/2 W. BELMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60634",
            "telephone_number": "773-237-4291",
            "fax_number": "773-237-4291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6027 W BELMONT AVE STE A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606345116",
            "telephone_number": "773-237-4291",
            "fax_number": "773-237-4291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHT SMILE DENTAL CLINIC, LTD.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRIGHT SMILE DENTAL CLINIC, LTD.",
        "enumeration_date": "2008-03-17",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "TAWOOSI",
        "authorized_official_first_name": "ABDULHASSAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-546-8317",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518155191",
            "state": "IL"
        }
    ],
    "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 Mar 17, 2008; 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.