Laramie Dental Care Center, Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

019025838 Issued in IL

Legal business name

LARAMIE DENTAL CARE CENTER, INC.

Practice address

2556 N Laramie Ave
Chicago, IL 60639-2452

Phone

(773) 889-3333

NPI assigned

Aug 18, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Maryam Moghadam, DDS

Title

President

Phone

(773) 889-3333

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250553600000",
    "number": "1588896906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2556 N LARAMIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606392452",
            "telephone_number": "773-889-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2556 N LARAMIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606392452",
            "telephone_number": "773-889-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARAMIE DENTAL CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-18",
        "last_updated": "2009-08-18",
        "status": "A",
        "authorized_official_last_name": "MOGHADAM",
        "authorized_official_first_name": "MARYAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-889-3333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019025838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rick Lara
• Larabida Children's Hospital
• Larabida Childrens Hospital
• Marci Lynn Laragh, M.D.
• Laramie Dental
• Alfred F Larcher Jr., DC
• Robert Lardner, P.T.
• Erin Marie Lareau, M.D.
• Olivia A Lares, D.D.S.
• Mackenzie Kathryn Large, OD

• Dental Clinic/Center in Chicago, IL
• Providers in Chicago, 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 Aug 18, 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.