NPIMap

Organization Active NPI

Griffin Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chicago, IL
National Provider Identifier
1659645182
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
021002361 Issued in IL
Legal business name
GRIFFIN ORTHODONTICS
Practice address
10019 S Western Ave
Chicago, IL 60643-1925
Phone
(773) 239-7696
NPI assigned
Mar 1, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

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

Authorized official

Name
Dr. Bonciel Latrice Griffin, DDS
Title
Orthodontist
Phone
(773) 239-7696

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 021002361 IL Primary

Addresses

Primary practice location

10019 S Western Ave
Chicago, IL 60643-1925

Mailing address

10019 S Western Ave
Chicago, IL 60643-1925
Phone (773) 239-7696

National Provider Directory

National Provider Directory
Tax ID family
Griffin Orthodontics PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10019 S Western Ave
Chicago, IL 60643
Phone (773) 239-7696

Practitioners & affiliated clinicians

Practitioners 1

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": "1330560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330560000000",
    "number": "1659645182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10019 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431925",
            "telephone_number": "773-239-7696"
        },
        {
            "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": "773-239-7696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRIFFIN ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-01",
        "last_updated": "2012-03-01",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "BONCIEL",
        "authorized_official_middle_name": "LATRICE",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "773-239-7696",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "021002361",
            "primary": true
        }
    ],
    "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 Mar 1, 2012; 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.