NPIMap

Organization Active NPI

Sonrisa Family Dental at the Hall, P.C.

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1831424548
Registry record updated Oct 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.026772 Issued in IL
Legal business name
SONRISA FAMILY DENTAL AT THE HALL, P.C.
Practice address
4608 A & B West Diversey Avenue
Chicago, IL 60639
Phone
(248) 210-8049
NPI assigned
Oct 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2009

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

Authorized official

Name
Dr. Mark Mendiola, D.D.S.
Title
Dentist/Owner
Phone
(248) 210-8049

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 019.026772 IL Primary

Addresses

Primary practice location

4608 A & B West Diversey Avenue
Chicago, IL 60639

Mailing address

4608 A & B West Diversey Avenue
Chicago, IL 60639
Phone (248) 210-8049

National Provider Directory

National Provider Directory

Locations

4608 W Diversey Ave
Ste A
Chicago, IL 60639
Phone (248) 210-8049

NPI Registry JSON

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

{
    "created_epoch": "1255478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255478400000",
    "number": "1831424548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4608 A & B WEST DIVERSEY AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60639",
            "telephone_number": "248-210-8049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4608 A & B WEST DIVERSEY AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60639",
            "telephone_number": "248-210-8049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONRISA FAMILY DENTAL AT THE HALL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-14",
        "last_updated": "2009-10-14",
        "status": "A",
        "authorized_official_last_name": "MENDIOLA",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "248-210-8049",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.026772",
            "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 Oct 14, 2009; 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.