NPIMap

Organization Active NPI

Advanced Family Dental & Orthodontics P C

  • Dentist
  • Crest Hill, IL
National Provider Identifier
1629360664
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019016447 Issued in IL
Legal business name
ADVANCED FAMILY DENTAL & ORTHODONTICS P C
Practice address
2241 Theodore St
Crest Hill, IL 60403-1881
Phone
(815) 741-1700
Fax
(815) 483-2298
NPI assigned
May 10, 2011
Last updated
Oct 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Authorized official

Name
Dr. David J Rubis, DDSNPI 1699873588
Title
President
Phone
(815) 741-1700

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
Dentist 122300000X 019016447 IL Primary

Addresses

Primary practice location

2241 Theodore St
Crest Hill, IL 60403-1881

Mailing address

2241 Theodore St
Crest Hill, IL 60403-1881
Phone (815) 741-1700

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": "1304985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1629360664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2241 THEODORE ST",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604031881",
            "telephone_number": "815-741-1700",
            "fax_number": "815-483-2298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2241 THEODORE ST",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604031881",
            "telephone_number": "815-741-1700",
            "fax_number": "815-483-2298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FAMILY DENTAL & ORTHODONTICS P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-10",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "RUBIS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-741-1700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019016447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crest Hill, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; 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.