Dental 360-Bucktown LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DENTAL 360-BUCKTOWN LLC

Practice address

2500 W North Ave
Chicago, IL 60647-5202

Phone

(773) 360-1281

NPI assigned

Jan 23, 2021

Last updated

Jan 23, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mohammed Parvez, DMD

Title

Member

Phone

(773) 798-9382

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1611360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611360000000",
    "number": "1689264616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475202",
            "telephone_number": "773-360-1281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL 360-BUCKTOWN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-23",
        "last_updated": "2021-01-23",
        "certification_date": "2021-01-23",
        "status": "A",
        "authorized_official_last_name": "PARVEZ",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "773-798-9382",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2021; 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.