Ida Mae Dental Clinic

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

019-025956 Issued in IL

Legal business name

IDA MAE DENTAL CLINIC

Practice address

8941 S Western Ave
Chicago, IL 60643-6432

Phone

(773) 951-5650

NPI assigned

Jan 18, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Shonna Renee Curry, DDS.

Title

Dental Director

Phone

(773) 951-5650

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516233600000",
    "number": "1750899282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8408 S SANGAMON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606203211",
            "telephone_number": "773-951-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8941 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606436432",
            "telephone_number": "773-951-5650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDA MAE DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-18",
        "last_updated": "2018-01-18",
        "status": "A",
        "authorized_official_last_name": "CURRY",
        "authorized_official_first_name": "SHONNA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "DENTAL DIRECTOR",
        "authorized_official_telephone_number": "773-951-5650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019-025956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iconic Optical
• Icz Medical Group
• Id
• Id Chicago Inc
• Ida Lillie Psychotherapy and Wellness
• James A Ida Jr., MD
• Jonathan Benjamin Ida, M.D.
• Josue Gedeon Otniel Idani
• Juan David Idarraga Parra, M.D.
• Sabrina Patricia Iddir, MD

• 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 Jan 18, 2018; 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.