NPIMap

Organization Active NPI

Ismile Dental LLC

  • Dentist
  • Chicago, IL
National Provider Identifier
1609210368
Registry record updated Apr 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
192.027782 Issued in IL
Legal business name
ISMILE DENTAL LLC
Practice address
4953 W Fullerton Ave
Chicago, IL 60639-2505
Phone
(773) 887-3244
Fax
(773) 887-3246
NPI assigned
Apr 24, 2013
Last updated
Apr 24, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2013

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

Authorized official

Name
Dr. Haytham Safi, DDSNPI 1922243369
Title
Sole Member
Phone
(773) 655-7455

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 192.027782 IL Primary

Addresses

Primary practice location

4953 W Fullerton Ave
Chicago, IL 60639-2505

Mailing address

4953 W Fullerton Ave
Chicago, IL 60639-2505
Phone (773) 887-3244

National Provider Directory

National Provider Directory

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": "1366761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366761600000",
    "number": "1609210368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4953 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606392505",
            "telephone_number": "773-887-3244",
            "fax_number": "773-887-3246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4953 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606392505",
            "telephone_number": "773-887-3244",
            "fax_number": "773-887-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISMILE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-24",
        "last_updated": "2013-04-24",
        "status": "A",
        "authorized_official_last_name": "SAFI",
        "authorized_official_first_name": "HAYTHAM",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "773-655-7455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "192.027782",
            "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 Apr 24, 2013; 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.