Chatham Dental Gallery

Primary specialty

DentistTaxonomy code 122300000X

License

019027749 Issued in IL

Legal business name

CHATHAM DENTAL GALLERY

Practice address

8544 S Stony Island Ave
Chicago, IL 60617-2248

Phone

(773) 221-0800

Fax

(773) 221-0868

NPI assigned

Aug 13, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Ogbonna Bankole Bowden, DDS

Title

President

Phone

(773) 793-1220

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1439424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445990400000",
    "number": "1629444625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8544 S STONY ISLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606172248",
            "telephone_number": "773-221-0800",
            "fax_number": "773-221-0868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8544 S STONY ISLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606172248",
            "telephone_number": "773-221-0800",
            "fax_number": "773-221-0868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHATHAM DENTAL GALLERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-13",
        "last_updated": "2015-10-28",
        "status": "A",
        "authorized_official_last_name": "BOWDEN",
        "authorized_official_first_name": "OGBONNA",
        "authorized_official_middle_name": "BANKOLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-793-1220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027749",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019020325",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029539",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tasha Chasson, LCSW
• Amanda Chastain
• Chataam Optical LLC
• Chandra Prakash Chataut, MD
• Francis Christopher Chaten, MD
• Chatham Dental, LTD
• Chatham Dentalworks PC
• Chatham Pharmacy Inc
• Chatham Satellite Senior Center
• Chatham Women'S Health

• Dentist in Chicago, IL
• Providers in Chicago, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2015; 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.