Midwest Dental Group

Primary specialty

DentistTaxonomy code 122300000X

License

019013845 Issued in IL

Legal business name

MIDWEST DENTAL GROUP

Practice address

2720 W 15TH St
114 Kling
Chicago, IL 60608-1610

Phone

(773) 257-6485

NPI assigned

May 22, 2008

Organization subpart

No

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

Authorized official

Name

David Horberg, D.D.S.NPI 1205825791

Title

Dentist

Phone

(773) 257-6485

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Horberg, D.D.S.

  • Dentist
  • Chicago, IL
  • NPI 1205825791
  NPD (past) Authorized official

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1710145065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 W 15TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081610",
            "telephone_number": "773-257-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 W 15TH ST",
            "address_2": "114 KLING",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081610",
            "telephone_number": "773-257-6485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "HORBERG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "773-257-6485",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019013845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 May 22, 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.