NPIMap

Organization Active NPI

Riverwest Smile Center

  • Dentist
  • Chicago, IL
National Provider Identifier
1639276876
Registry record updated Apr 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019016207 Issued in IL
Legal business name
RIVERWEST SMILE CENTER
Practice address
875 N Milwaukee Ave
Chicago, IL 60622-4188
Phone
(312) 455-9800
Fax
(312) 455-9803
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2009

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

Authorized official

Name
Jeanine Solis
Title
Office Manager
Phone
(312) 455-9800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 019016207 IL Primary

Addresses

Primary practice location

875 N Milwaukee Ave
Chicago, IL 60622-4188

Mailing address

875 N Milwaukee Ave
Chicago, IL 60622-4188
Phone (312) 455-9800

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239580800000",
    "number": "1639276876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606224188",
            "telephone_number": "312-455-9800",
            "fax_number": "312-455-9803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606224188",
            "telephone_number": "312-455-9800",
            "fax_number": "312-455-9803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERWEST SMILE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2009-04-13",
        "status": "A",
        "authorized_official_last_name": "SOLIS",
        "authorized_official_first_name": "JEANINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "312-455-9800"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019016207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 13, 2009; 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.