Individual provider Active NPI

Clifford Anthony Zmick, D.D.S., M.S.

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1790819969
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19A15572 Issued in IL
Practice address
7020 W North Ave
Chicago, IL 60707-4306
Phone
(773) 745-8300
Fax
(773) 745-8385
NPI assigned
Mar 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 19A15572 IL Primary

Addresses

Primary practice location

7020 W North Ave
Chicago, IL 60707-4306

Mailing address

3648 Indian Wells LN
Northbrook, IL 60062-3102
Phone (773) 745-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
19A15572ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
North Ave. Dental Partners P.C. General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790819969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3648 INDIAN WELLS LN",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600623102",
            "telephone_number": "773-745-8300",
            "fax_number": "773-745-8385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7020 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "607074306",
            "telephone_number": "773-745-8300",
            "fax_number": "773-745-8385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZMICK",
        "first_name": "CLIFFORD",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19A15572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

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