NPIMap

Organization Active NPI

Ultimate Dental Partners, LLC

  • Dentist
  • Chicago, IL
National Provider Identifier
1629584891
Registry record updated Dec 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019026667 Issued in IL
Legal business name
ULTIMATE DENTAL PARTNERS, LLC
Doing business as
milwaukee dental clinic
Practice address
4254 N Milwaukee Ave
Chicago, IL 60641-1643
Phone
(773) 282-7906
Fax
(773) 427-2740
NPI assigned
Dec 23, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2017

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

Authorized official

Name
Dr. Sibtain Kerai, DDS
Title
Manager/ Partner
Phone
(312) 231-7601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019026667 IL Primary

Addresses

Primary practice location

4254 N Milwaukee Ave
Chicago, IL 60641-1643

Mailing address

4254 N Milwaukee Ave
Chicago, IL 60641-1643
Phone (773) 282-7906

Other names 1

  • milwaukee dental clinic Doing business as

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.

NPI Registry JSON

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

{
    "created_epoch": "1513987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513987200000",
    "number": "1629584891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4254 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411643",
            "telephone_number": "773-282-7906",
            "fax_number": "773-427-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4254 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411643",
            "telephone_number": "773-282-7906",
            "fax_number": "773-427-2740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTIMATE DENTAL PARTNERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-23",
        "last_updated": "2017-12-23",
        "status": "A",
        "authorized_official_last_name": "KERAI",
        "authorized_official_first_name": "SIBTAIN",
        "authorized_official_title_or_position": "MANAGER/ PARTNER",
        "authorized_official_telephone_number": "312-231-7601",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019026667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "milwaukee dental clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 23, 2017; 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.