NPIMap

Organization Active NPI

MG Dentistry

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
National Provider Identifier
1710422969
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
019022121 Issued in IL
Legal business name
MG DENTISTRY
Practice address
111 N Wabash Ave
Suite 1820
Chicago, IL 60602-1903
Phone
(312) 236-3633
Fax
(312) 236-7770
NPI assigned
Dec 27, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2016

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

Authorized official

Name
Maria Luisa Gracias, DDS
Title
Owner
Phone
(312) 236-3633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 019022121 IL Primary

Addresses

Primary practice location

111 N Wabash Ave
Suite 1820
Chicago, IL 60602-1903

Mailing address

111 N Wabash Ave
Suite 1820
Chicago, IL 60602-1903
Phone (312) 236-3633

National Provider Directory

National Provider Directory
Tax ID family
MG Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1482796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482796800000",
    "number": "1710422969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N WABASH AVE",
            "address_2": "SUITE 1820",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021903",
            "telephone_number": "312-236-3633",
            "fax_number": "312-236-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N WABASH AVE",
            "address_2": "SUITE 1820",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021903",
            "telephone_number": "312-236-3633",
            "fax_number": "312-236-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MG DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-27",
        "last_updated": "2016-12-27",
        "status": "A",
        "authorized_official_last_name": "GRACIAS",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "LUISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-236-3633",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "019022121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; 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.