NPIMap

Organization Active NPI

Gina L. Tambornini DDS Inc

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1861648818
Registry record updated Jul 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019203206 Issued in IL
Legal business name
GINA L. TAMBORNINI DDS INC
Practice address
1640 N Wells St.
Suite 205
Chicago, IL 60614-6006
Phone
(312) 642-4218
Fax
(312) 642-6419
NPI assigned
Aug 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2012

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

Authorized official

Name
Gina Lyn Tambornini, D.D.S.NPI 1730526054
Title
Dentist/President
Phone
(312) 642-4218

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019203206 IL Primary

Addresses

Primary practice location

1640 N Wells St.
Suite 205
Chicago, IL 60614-6006

Mailing address

1640 N Wells St.
Suite 205
Chicago, IL 60614-6006
Phone (312) 642-4218

National Provider Directory

National Provider Directory

Locations

1640 N Wells St
Unit 205
Chicago, IL 60614
Phone (312) 642-4218

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1218412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342483200000",
    "number": "1861648818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 N WELLS ST.",
            "address_2": "SUITE 205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606146006",
            "telephone_number": "312-642-4218",
            "fax_number": "312-642-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 N WELLS ST.",
            "address_2": "SUITE 205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606146006",
            "telephone_number": "312-642-4218",
            "fax_number": "312-642-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GINA L. TAMBORNINI DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-11",
        "last_updated": "2012-07-17",
        "status": "A",
        "authorized_official_last_name": "TAMBORNINI",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "DENTIST/PRESIDENT",
        "authorized_official_telephone_number": "312-642-4218",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019203206",
            "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 Jul 17, 2012; 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.