Jason Difani, DDS, PC

Primary specialty

DentistTaxonomy code 122300000X

License

019027928 Issued in IL

Legal business name

JASON DIFANI, DDS, PC

Practice address

5050 S Kedzie Ave Unit a
Chicago, IL 60632-3009

Phone

(773) 778-2200

Fax

(773) 778-2202

NPI assigned

Jun 20, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Jason T Difani, DDS

Title

Owner

Phone

(309) 824-8835

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308528000000",
    "number": "1689960593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1843 W ROSCOE ST APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606571102",
            "telephone_number": "309-824-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 S KEDZIE AVE UNIT A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606323009",
            "telephone_number": "773-778-2200",
            "fax_number": "773-778-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON DIFANI, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-20",
        "last_updated": "2011-06-20",
        "status": "A",
        "authorized_official_last_name": "DIFANI",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-824-8835",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Marie Jaskula, APN
• Jasmin M. Weaver, LCPC & Associates LLC
• Jasmine Healthcare Management LLC
• Jasmine Singh M.D, S.C.
• Jasminka Kostic, M.D.,S.C.
• Jason Hacker PH.D. Therapy and Psychological Services LLC
• Jason M Grinter DDS PC
• Jason P. Godo, DC, SC
• Jason Schrotenboer DDS MD PC
• Jason W Ingham DC SC

• 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 Jun 20, 2011; 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.