NPIMap

Organization Active NPI

Agarwal Dental Clinic

  • Federally Qualified Health Center (FQHC)
  • Chicago Heights, IL
National Provider Identifier
1770661019
Registry record updated Aug 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
AGARWAL DENTAL CLINIC
Practice address
1415 Emerald Ave
Chicago Heights, IL 60411-3517
Phone
(708) 756-7384
NPI assigned
Nov 2, 2006
Last updated
Aug 10, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
ACCESS COMMUNITY HEALTH NETWORKAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 10, 2007

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

Authorized official

Name
Donna Thompson
Title
Ceo
Phone
(773) 257-6770

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1415 Emerald Ave
Chicago Heights, IL 60411-3517

Mailing address

1501 S California Ave
Chicago, IL 60608-1732
Phone (773) 257-6770

National Provider Directory

National Provider Directory
Tax ID family
Access Comunity Health29 organizations share this tax ID, including this one
Part of
Access Comunity Health

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186704000000",
    "number": "1770661019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081732",
            "telephone_number": "773-257-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 EMERALD AVE",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604113517",
            "telephone_number": "708-756-7384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGARWAL DENTAL CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ACCESS COMMUNITY HEALTH NETWORK",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-08-10",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "773-257-6770"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.