Bonciel Latrice Griffin-Burress, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019-025726 Issued in IL

Practice address

10019 S Western Ave
Chicago, IL 60643-1925

Phone

(773) 728-5333

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Bonciel Latrice Griffin-Burress Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Griffin Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chicago, IL
  • NPI 1659645182
  NPD (past)
• Griffin Orthodontics PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chicago, IL
  • NPI 1821429804
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1639281827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 S LANGLEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606151515",
            "telephone_number": "773-640-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10019 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431925",
            "telephone_number": "773-728-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN-BURRESS",
        "first_name": "BONCIEL",
        "middle_name": "LATRICE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-025726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BONCIEL",
            "last_name": "GRIFFIN-BURRESS",
            "middle_name": "LATRICE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Megan Griesel, PSYD
• Emily Griesemer, CRNA
• Griffin Orthodontics
• Griffin Orthodontics PC
• Griffin Orthodontics PC
• Alexander Bradley Griffin, M.D.
• Alison Marie Griffin, MD
• Alizah Griffin
• Angel I Griffin
• Angela J Griffin, MD

• 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 Nov 21, 2013; 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.