NPIMap

Organization Active NPI

Family Dental Care of the East Side

  • Dentist
  • Chicago, IL
National Provider Identifier
1902016520
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
FAMILY DENTAL CARE OF THE EAST SIDE
Practice address
10601 S Avenue E
Chicago, IL 60617-6316
Phone
(773) 978-5828
NPI assigned
May 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Harry Varvaresso
Title
Ex Director
Phone
(773) 978-1231

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X IL Primary

Addresses

Primary practice location

10601 S Avenue E
Chicago, IL 60617-6316

Mailing address

10601 S Avenue E
Chicago, IL 60617-6316
Phone (773) 978-5828

National Provider Directory

National Provider Directory
Tax ID family
Family Dental Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902016520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10601 S AVENUE E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606176316",
            "telephone_number": "773-978-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10601 S AVENUE E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606176316",
            "telephone_number": "773-978-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL CARE OF THE EAST SIDE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VARVARESSO",
        "authorized_official_first_name": "HARRY",
        "authorized_official_title_or_position": "EX DIRECTOR",
        "authorized_official_telephone_number": "773-978-1231"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "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 Aug 22, 2020; 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.