Randolph Dental Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

RANDOLPH DENTAL INC

Practice address

1342 W Randolph St
Chicago, IL 60607-1526

Phone

(312) 767-0407

NPI assigned

Oct 30, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Nawar Alnoman, DDS

Title

President

Phone

(312) 767-0407

Specialties & licenses 1

Addresses

Other names 1

• Millennium Dental Group Doing business as

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572393600000",
    "number": "1740824036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1342 W RANDOLPH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071526",
            "telephone_number": "312-767-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1342 W RANDOLPH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071526",
            "telephone_number": "312-767-0407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDOLPH DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-30",
        "last_updated": "2019-10-30",
        "status": "A",
        "authorized_official_last_name": "ALNOMAN",
        "authorized_official_first_name": "NAWAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-767-0407",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Millennium Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kyle L Randle
• Latoya Randle
• Ryan Randle, MD
• Nancy Randleman, M.S.W, L.C.S.W.
• Chiyoko Rando, PA-C
• Amber Tiffany Randolph, MD
• Guy Robert Randolph, M.D.
• Helen Asberry Randolph, PHAM.D.
• Pavielle Randolph
• Richard Randolph

• 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 Oct 30, 2019; 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.