NPIMap

Organization Active NPI

Jason R. Crescenzo, DDS, P.C.

  • Dental Clinic/Center
  • Tinley Park, IL
National Provider Identifier
1629374046
Registry record updated Feb 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
019027570 Issued in IL
Legal business name
JASON R. CRESCENZO, DDS, P.C.
Doing business as
Aesthetic Family Dental of Tinley Park
Practice address
16345 Harlem Ave Ste 160
Tinley Park, IL 60477-2589
Phone
(708) 781-9754
Fax
(708) 781-9758
NPI assigned
Feb 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2011

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

Authorized official

Name
Dr. Jason R Crescenzo, DDSNPI 1114192838
Title
President
Phone
(708) 781-9754

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 019027570 IL Primary

Addresses

Primary practice location

16345 Harlem Ave Ste 160
Tinley Park, IL 60477-2589

Mailing address

16345 Harlem Ave Ste 160
Tinley Park, IL 60477-2589
Phone (708) 781-9754

Other names 1

  • Aesthetic Family Dental of Tinley Park Doing business as

National Provider Directory

National Provider Directory

Locations

16345 Harlem Ave
Ste 160
Tinley Park, IL 60477
Phone (708) 781-9754

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1296604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296604800000",
    "number": "1629374046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16345 HARLEM AVE STE 160",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772589",
            "telephone_number": "708-781-9754",
            "fax_number": "708-781-9758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16345 HARLEM AVE STE 160",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772589",
            "telephone_number": "708-781-9754",
            "fax_number": "708-781-9758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON R. CRESCENZO, DDS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-02",
        "last_updated": "2011-02-02",
        "status": "A",
        "authorized_official_last_name": "CRESCENZO",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-781-9754",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019027570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aesthetic Family Dental of Tinley Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2011; 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.