Dentum Dental LTD

Primary specialty

DentistTaxonomy code 122300000X

License

019020204 Issued in IL

Legal business name

DENTUM DENTAL LTD

Practice address

5500 S Damen Ave
Chicago, IL 60636-1107

Phone

(312) 949-9000

NPI assigned

Mar 12, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Faizan Mir

Title

Manager

Phone

(312) 949-9000

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1520812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525996800000",
    "number": "1649773144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 N WEBER RD # 397",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604901569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 S DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606361107",
            "telephone_number": "312-949-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTUM DENTAL LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-12",
        "last_updated": "2018-05-11",
        "status": "A",
        "authorized_official_last_name": "MIR",
        "authorized_official_first_name": "FAIZAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "312-949-9000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019020204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019020204",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dentistry for Children and Families
• Dentologie, PC
• Heather Jane-Bates Denton, LMFT
• Nyana Denton
• Dentpol
• Sarah Dentz
• Michael Denz, D.O.
• Aditi Deokar
• Madhvi Deol, MD
• Manas Deolankar, 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 May 11, 2018; 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.