A&W Dental Associates

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

A&W DENTAL ASSOCIATES

Practice address

8301 S Brandon Ave
Chicago, IL 60617-2656

Phone

(773) 375-6199

NPI assigned

May 25, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stewart Gordon Willoughby, D.D.S., M.S.NPI 1659424232

Title

General Partner

Phone

(773) 375-6199

Specialties & licenses 1

Addresses

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.

• Stewart Gordon Willoughby, DDS LDS RCS MS

  • Dentist
  • Chicago, IL
  • NPI 1659424232
  Authorized official Same address or phone

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629289913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 S BRANDON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606172656",
            "telephone_number": "773-375-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 S BRANDON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606172656",
            "telephone_number": "773-375-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A&W DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLOUGHBY",
        "authorized_official_first_name": "STEWART",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "773-375-6199",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Chicago, IL
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• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.