NPIMap

Organization Active NPI

Chicago Lake Family Dental LLC

  • Dental Clinic/Center
  • Minneapolis, MN
National Provider Identifier
1770095028
Registry record updated Oct 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
CHICAGO LAKE FAMILY DENTAL LLC
Practice address
2900 Chicago Ave
Minneapolis, MN 55407-1322
Phone
(612) 823-2080
NPI assigned
Oct 26, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2017

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

Authorized official

Name
Dr. Ali Barbarawi, DMD
Title
General Dentist
Phone
(612) 823-2080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

2900 Chicago Ave
Minneapolis, MN 55407-1322

Mailing address

4893 Boatman LN
Inver Grove Heights, MN 55076-1160

National Provider Directory

National Provider Directory

Locations

2900 Chicago Ave
Minneapolis, MN 55407
Phone (612) 823-2080

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508976000000",
    "number": "1770095028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4893 BOATMAN LN",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550761160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071322",
            "telephone_number": "612-823-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO LAKE FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-26",
        "last_updated": "2017-10-26",
        "status": "A",
        "authorized_official_last_name": "BARBARAWI",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "612-823-2080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; 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.