Kedzie Dental Clinic

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

KEDZIE DENTAL CLINIC

Practice address

6035 N Kedzie Ave
Chicago, IL 60659-2406

Phone

(773) 274-9514

NPI assigned

Jan 12, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Khairunnisa Shaikh

Title

Owner

Phone

(773) 274-9514

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1452556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452556800000",
    "number": "1841656436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6035 N KEDZIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606592406",
            "telephone_number": "773-274-9514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6035 N KEDZIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606592406",
            "telephone_number": "773-274-9514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEDZIE DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-12",
        "last_updated": "2016-01-12",
        "status": "A",
        "authorized_official_last_name": "SHAIKH",
        "authorized_official_first_name": "KHAIRUNNISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-274-9514",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rediet Getu Kebede, MD
• Tanya Kechker, O.D.
• Sabrina Marie Keck, D.P.T.
• Susan A. Kecskes, M.D.
• Kedzie 47 Dental LLC
• Kedzie Dentistry LLC
• Kedzie Drugs Inc
• Kedzie Medical Clinic Inc
• Anna Kedzierska
• Alla Kedzierski

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2016; 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.