Dr Zishan Bader DDS SC

Primary specialty

DentistTaxonomy code 122300000X

License

019028083 Issued in IL

Legal business name

DR ZISHAN BADER DDS SC

Practice address

654 E 47TH St
Chicago, IL 60653-4224

Phone

(773) 624-5800

NPI assigned

Feb 1, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Zishan Bader, DDS

Title

President

Phone

(708) 369-6232

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1485907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485907200000",
    "number": "1891233672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 E 47TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606534224",
            "telephone_number": "773-624-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 E 47TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606534224",
            "telephone_number": "773-624-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR ZISHAN BADER DDS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-01",
        "last_updated": "2017-02-01",
        "status": "A",
        "authorized_official_last_name": "BADER",
        "authorized_official_first_name": "ZISHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-369-6232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019028083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019028083",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; 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.