Illinois Dental Arts P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ILLINOIS DENTAL ARTS P.C.

Practice address

5600 South Wolf Road
Suite 130
Western Springs, IL 60558-2254

Phone

(708) 246-1666

NPI assigned

Nov 14, 2008

Last updated

Nov 14, 2008By 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. Vlad Fedin, D.D.S.

Title

Dentist President

Phone

(708) 246-1666

Specialties & licenses 1

Addresses

Tax ID family

Illinois Dental Arts PC2 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.

• Illinois Dental Arts, P.C.

  • General Practice Dentistry
  • Western Springs, IL
  • NPI 1588857114
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vladimir Fedin, DDS

  • General Practice Dentistry
  • Western Springs, IL
  • NPI 1811017007
  NPD (past)

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

{
    "created_epoch": "1226620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226620800000",
    "number": "1730333972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 SOUTH WOLF ROAD",
            "address_2": "SUITE 130",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605582254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 SOUTH WOLF ROAD",
            "address_2": "SUITE 130",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605582254",
            "telephone_number": "708-246-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS DENTAL ARTS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-14",
        "last_updated": "2008-11-14",
        "status": "A",
        "authorized_official_last_name": "FEDIN",
        "authorized_official_first_name": "VLAD",
        "authorized_official_title_or_position": "DENTIST PRESIDENT",
        "authorized_official_telephone_number": "708-246-1666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devon Holcomb, M.S.W, LSW
• Tanya A Hryhorczuk, PHARMD
• Jenna M Hultgren
• Illinois Bone and Joint Institute LLC
• Illinois Bone and Joint Institute LLC
• Illinois Dental Arts, P.C.
• Stefanie J. Irby, LCSW
• Dowlin Johnson, PHARMD.
• Rupal Johnson, PHARMD
• Margaret Kachadurian, LSW

• General Practice Dentistry in Western Springs, IL
• Providers in Western Springs, 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 Nov 14, 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.