Ac Dentistry, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

019025709 Issued in IL

Legal business name

AC DENTISTRY, LLC

Practice address

1209 W Diversey Pkwy
Chicago, IL 60614-1201

Phone

(773) 327-8550

Fax

(773) 327-8565

NPI assigned

Apr 27, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Adrian Codel, DDS

Title

Dentist

Phone

(773) 327-8550

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1209254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209254400000",
    "number": "1700051141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 W DIVERSEY PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141201",
            "telephone_number": "773-327-8550",
            "fax_number": "773-327-8565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 W DIVERSEY PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141201",
            "telephone_number": "773-327-8550",
            "fax_number": "773-327-8565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AC DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-27",
        "last_updated": "2008-04-27",
        "status": "A",
        "authorized_official_last_name": "CODEL",
        "authorized_official_first_name": "ADRIAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "773-327-8550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019025709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mahmoud Abusaoud
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• 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 27, 2008; 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.