Silvio J Camodeca DDS DN

Primary specialty

DentistTaxonomy code 122300000X

License

019015351 Issued in IL

Legal business name

SILVIO J CAMODECA DDS DN

Doing business as

Avenue Dental Clinic & Lab

Practice address

3518 W Fullerton Ave
Chicago, IL 60647

Phone

(773) 278-0334

Fax

(773) 365-0314

NPI assigned

Jan 4, 2006

Last updated

Aug 30, 2007By 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. Silvio J Camodeca, DDS DNNPI 1467626705

Title

Owner

Phone

(773) 278-0334

Specialties & licenses 4

Addresses

Other identifiers 4

Other names 1

• Avenue Dental Clinic & Lab Doing business as

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.

• Silvio J Camodeca, DDS

  • Dentist
  • Chicago, IL
  • NPI 1467626705
  Authorized official Same address or phone

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188432000000",
    "number": "1740268416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3518 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60647",
            "telephone_number": "773-278-0334",
            "fax_number": "773-365-0314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3518 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60647",
            "telephone_number": "773-278-0334",
            "fax_number": "773-365-0314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVIO J CAMODECA DDS DN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-04",
        "last_updated": "2007-08-30",
        "status": "A",
        "authorized_official_last_name": "CAMODECA",
        "authorized_official_first_name": "SILVIO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-278-0334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS DN"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12010C12A",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019015351",
            "primary": true
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "DC",
            "license": "NAT1000255",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "IL",
            "license": "181000299",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTISTRY",
            "identifier": "12010612A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NAPRAPATH",
            "identifier": "181000299",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATUROPATHY",
            "identifier": "NAT1000255",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTISTRY",
            "identifier": "019015351",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avenue Dental Clinic & Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Elaine Hernandez Silvestre, OD
• Ashley Elizabeth Silvestri
• Jean M Silvestri, M.D.
• Mara Silvestri, LPC
• Silvia M Pelini PC
• Daniel J Silvio, PA-C
• Gabriel Sim, D.D.S.
• Justin Lee Sim
• Yung Chul Sim, MD
• Natalie Simak, MD

• 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 Aug 30, 2007; 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.