Family Millennium Dentistry, Inc.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

021001094 Issued in IL

Legal business name

FAMILY MILLENNIUM DENTISTRY, INC.

Doing business as

Millennium Dental Group

Practice address

1342 W Randolph St
Chicago, IL 60607-1522

Phone

(312) 767-0407

Fax

(312) 988-0292

NPI assigned

Mar 13, 2016

Last updated

Apr 8, 2016By 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

Lawrence H Zager, D.D.S. PC

Title

Dentist / Owner

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": "1457827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460073600000",
    "number": "1790146132",
    "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": "606071522",
            "telephone_number": "312-767-0407",
            "fax_number": "312-988-0292"
        },
        {
            "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": "606071522",
            "telephone_number": "312-767-0407",
            "fax_number": "312-988-0292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MILLENNIUM DENTISTRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-13",
        "last_updated": "2016-04-08",
        "status": "A",
        "authorized_official_last_name": "ZAGER",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DENTIST / OWNER",
        "authorized_official_telephone_number": "312-767-0407",
        "authorized_official_credential": "D.D.S. PC"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "021001094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MILLENNIUM DENTAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in Chicago, IL
• Providers in Chicago, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2016; 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.