Active NPI
Brian Remiasz, DMD
- General Practice Dentistry
- Chicago, IL
National Provider Identifier
1609612779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019.035302
- Practice address
- 6615 W Archer Ave
Chicago, IL 60638-2407 - Phone
- (773) 586-9700
- NPI assigned
- Jul 8, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019.035302 | IL | Primary |
Addresses
Primary practice location
6615 W Archer Ave
Chicago, IL 60638-2407
Mailing address
11000 S Theresa Cir Apt 3B
Palos Hills, IL 60465-2400
Phone (708) 257-3722
Other practice location 1
5850 111th St
Chicago Ridge, IL 60415-2220
Phone (773) 233-1249
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.035302 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Archer Family Dental LTD | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720396800000",
"number": "1609612779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11000 S THERESA CIR APT 3B",
"city": "PALOS HILLS",
"state": "IL",
"postal_code": "604652400",
"telephone_number": "708-257-3722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6615 W ARCHER AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606382407",
"telephone_number": "773-586-9700"
}
],
"practiceLocations": [
{
"address_1": "5850 111th St",
"address_purpose": "LOCATION",
"city": "Chicago Ridge",
"state": "IL",
"postal_code": "604152220",
"country_code": "US",
"telephone_number": "773-233-1249",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REMIASZ",
"first_name": "BRIAN",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-07-08",
"last_updated": "2024-07-08",
"certification_date": "2024-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019.035302",
"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 Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.