Old Town Dental Center

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

019024754 Issued in IL

Legal business name

OLD TOWN DENTAL CENTER

Practice address

333 W North Ave
Chicago, IL 60610-1293

Phone

(312) 751-1113

NPI assigned

Mar 30, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Vlad Ferdkoff

Title

President

Phone

(312) 751-1113

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269907200000",
    "number": "1659696995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606101293",
            "telephone_number": "312-751-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606101293",
            "telephone_number": "312-751-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD TOWN DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-30",
        "last_updated": "2010-03-30",
        "status": "A",
        "authorized_official_last_name": "FERDKOFF",
        "authorized_official_first_name": "VLAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-751-1113",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019024754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Silvia Olayo
• Olb Services LLC
• Katarzyna Olbrycht-Ciszewski, ST
• Old Irving Chiropractic & Wellness Center, LLC
• Old Town Dental Care, P.C.
• Old Town Eye Care LLC
• Paula Oldeg, M.D.
• James Oldenburg, OTR/L
• Molly Older, LCSW
• Kelley Oldham, L.C.P.C

• 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 Mar 30, 2010; 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.