NPIMap

Organization Active NPI

Evergreen Smiles Dental

  • Dental Clinic/Center
  • Evergreen Park, IL
National Provider Identifier
1649058728
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
EVERGREEN SMILES DENTAL
Practice address
9541 S Pulaski Rd
Evergreen Park, IL 60805-1911
Phone
(708) 424-2220
NPI assigned
Sep 19, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Authorized official

Name
Rohi Atassi, DDS
Title
Managing Partner
Phone
(312) 622-4406

Specialties & licenses 1

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

Addresses

Primary practice location

9541 S Pulaski Rd
Evergreen Park, IL 60805-1911

Mailing address

9541 S Pulaski Rd
Evergreen Park, IL 60805-1911

National Provider Directory

National Provider Directory

Locations

9541 S Pulaski Rd
Evergreen Park, IL 60805
Phone (708) 424-2220

Practitioners & affiliated clinicians

Practitioners 6

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": "1695081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695081600000",
    "number": "1649058728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9541 S PULASKI RD",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608051911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9541 S PULASKI RD",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608051911",
            "telephone_number": "708-424-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN SMILES DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-19",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A",
        "authorized_official_last_name": "ATASSI",
        "authorized_official_first_name": "ROHI",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "312-622-4406",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.