JDM DDS PC

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

Legal business name

JDM DDS PC

Practice address

6315 N Milwaukee Ave
Chicago, IL 60646-3760

Phone

(773) 774-1493

NPI assigned

Jul 25, 2022

Organization subpart

No

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

Authorized official

Name

Dr. John D Manikowski, DDS

Title

President

Phone

(312) 213-4179

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• JACK D MANIKOWSKI DDS PC Other name

Electronic endpoints 1

Locations

Practitioners 3

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

• Jack D Manikowski, DDS PC

  • Dentist
  • Chicago, IL
  • NPI 1710146964
  NPD
• James Nicholas Ciesco, DDS

  • Dentist
  • Chicago, IL
  • NPI 1558411603
  NPD (past)
• Roman Daniel Mycyk, DDS

  • Dentist
  • Chicago, IL
  • NPI 1528118676
  NPD (past)

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

{
    "created_epoch": "1658707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658707200000",
    "number": "1811623788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 N SHEFFIELD AVE STE 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606145549",
            "telephone_number": "312-337-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6315 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606463760",
            "telephone_number": "773-774-1493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JDM DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-25",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A",
        "authorized_official_last_name": "MANIKOWSKI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-213-4179",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1710146964",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "DENTRIXASCEND",
            "affiliation": "Y",
            "endpointDescription": "DENTALSOFTWARE",
            "affiliationName": "JACK D MANIKOWSKI",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "DENTALSOFTWARE",
            "address_1": "6315 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606463760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "JACK D MANIKOWSKI DDS PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• JCH Counseling, LLC
• JCT Community Care Network NFP
• JD Dental Studio Inc
• JD Feldman DDS, LW Feldman DDS & Associates PC
• JD Manikowski, D.D.S., LLC
• Mohammad Jeafar, RPH
• Amyola Jean Baptiste
• Anne Laurie Jean Jacques
• Jean Lee MD SC
• Athalie Jean-Baptiste

• Public Health Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• Public Health Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.