Brickyard Orthodontics

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

BRICKYARD ORTHODONTICS

Practice address

6018 W Diversey Ave
Chicago, IL 60639-1108

Phone

(773) 836-7846

Fax

(773) 622-6191

NPI assigned

Apr 7, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Ernest Panos, D.D.S

Title

President

Phone

(773) 836-7846

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207526400000",
    "number": "1821261397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6018 W DIVERSEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391108",
            "telephone_number": "773-836-7846",
            "fax_number": "773-622-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6018 W DIVERSEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391108",
            "telephone_number": "773-836-7846",
            "fax_number": "773-622-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRICKYARD ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-07",
        "last_updated": "2008-04-07",
        "status": "A",
        "authorized_official_last_name": "PANOS",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-836-7846",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clifford Brickman, DN, DCSW, LCSW
• Wendy Joy Brickman, MD
• Mack Brickner, LPC
• Shawn Elyse Brickner, M.D.,
• Brickyard Dental Center
• Bridge to Connection
• Yolanda Bridgeforth
• Mary Catherine Bridgeland, LPC
• Madeline Bridgeman, PT, DPT
• Shikota Bridgemon

• Orthodontics and Dentofacial Orthopedics Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; 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.