Diversey Dental Center

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DIVERSEY DENTAL CENTER

Practice address

5300 W Diversey Ave
Chicago, IL 60639

Phone

(773) 202-1500

Fax

(773) 202-1697

NPI assigned

Feb 6, 2007

Last updated

Aug 22, 2020By 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

Ms. Veronica Hernandez

Title

Office Manager

Phone

(773) 202-1500

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth N. Meyer, D.D.S.

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1568672814
  NPD (past)

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790824654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 W DIVERSEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60639",
            "telephone_number": "773-202-1500",
            "fax_number": "773-202-1697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 W DIVERSEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60639",
            "telephone_number": "773-202-1500",
            "fax_number": "773-202-1697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSEY DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "773-202-1500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diva Resource Connection Inc
• Aaron Gerardo Divanne Gabot, M.D.
• Divergent Path Therapy, PLLC
• Divers Psychotherapy LLC
• Diverse Investments Inc.
• Diversey Family Dental, P.C.
• Diversey Health Care Clinic Inc (Diversey HealthCare Clinic)
• Diversey Medical Center SC
• Diversfied Emergency Services, LLC
• Diversified Behavioral Services

• Dentist in Chicago, IL
• Providers in Chicago, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.