Portage Park Dental Studio

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PORTAGE PARK DENTAL STUDIO

Practice address

5955 W Irving Park Rd
Chicago, IL 60634-2618

Phone

(773) 481-9455

NPI assigned

Apr 2, 2022

Organization subpart

No

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

Authorized official

Name

Darren Dwayne Simpson, DDS

Title

Owner

Phone

(708) 369-4076

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bryan Tran

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1033857800
  NPD
• Maureen Copeland, D.D.S.

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1922248970
  NPD (past)

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

{
    "created_epoch": "1648857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648857600000",
    "number": "1659012920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 LAURA LN",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605175062",
            "telephone_number": "708-369-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606342618",
            "telephone_number": "773-481-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTAGE PARK DENTAL STUDIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-02",
        "last_updated": "2022-04-02",
        "certification_date": "2022-04-02",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "DARREN",
        "authorized_official_middle_name": "DWAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-369-4076",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arielle Port, MD
• Ana Porta
• Emily Porta
• Nicolas FM Porta, MD
• Portage Park Dental Associates, LTD
• Portage Park Medical Group
• Portage Park Satellite Senior Center
• Jasmin Portaz
• Alexander Jay Porte, M.D.
• Michael A Porte, MD

• Dental Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2022; 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.