Austriaco Dental Associates LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019021311 Issued in IL

Legal business name

AUSTRIACO DENTAL ASSOCIATES LLC

Doing business as

Aspen Dental

Practice address

7310 Walton St Ste a
Rockford, IL 61108-4614

Phone

(866) 273-8204

Fax

(866) 803-4943

NPI assigned

Apr 3, 2013

Last updated

Apr 3, 2013By 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

Jerome Austriaco, DDS

Title

Owner

Phone

(866) 273-8204

Specialties & licenses 1

Addresses

Other names 1

• Aspen Dental Doing business as

Locations

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364947200000",
    "number": "1750624110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189",
            "telephone_number": "866-273-8204",
            "fax_number": "866-803-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7310 WALTON ST STE A",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611084614",
            "telephone_number": "866-273-8204",
            "fax_number": "866-803-4943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUSTRIACO DENTAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-03",
        "last_updated": "2013-04-03",
        "status": "A",
        "authorized_official_last_name": "AUSTRIACO",
        "authorized_official_first_name": "JEROME",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "866-273-8204",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019021311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspen Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Rockford, IL
• Providers in Rockford, 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 Apr 3, 2013; 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.