NPIMap

Organization Active NPI

Glamour Dental Care, PC

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1649677717
Registry record updated Dec 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019025140 Issued in IL
Legal business name
GLAMOUR DENTAL CARE, PC
Practice address
6825 W Addison St
Chicago, IL 60634-3702
Phone
(773) 736-6610
Fax
(773) 736-6614
NPI assigned
Dec 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2014

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

Authorized official

Name
Monika TyszkowskiNPI 1598923385
Title
President
Phone
(773) 736-6610

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 019025140 IL Primary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 019025140 IL

Addresses

Primary practice location

6825 W Addison St
Chicago, IL 60634-3702

Mailing address

6825 W Addison St
Chicago, IL 60634-3702
Phone (773) 736-6610

National Provider Directory

National Provider Directory

Locations

6825 W Addison St
Chicago, IL 60634
Phone (773) 736-6610

Practitioners & affiliated clinicians

Practitioners 3

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": "1417651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417651200000",
    "number": "1649677717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6825 W ADDISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606343702",
            "telephone_number": "773-736-6610",
            "fax_number": "773-736-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6825 W ADDISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606343702",
            "telephone_number": "773-736-6610",
            "fax_number": "773-736-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLAMOUR DENTAL CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-04",
        "last_updated": "2014-12-04",
        "status": "A",
        "authorized_official_last_name": "TYSZKOWSKI",
        "authorized_official_first_name": "MONIKA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-736-6610"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025140",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019025140",
            "primary": false
        }
    ],
    "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 Dec 4, 2014; 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.