Dental Shine III P C

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

019026154 Issued in IL

Legal business name

DENTAL SHINE III P C

Practice address

2902 W 63Rd St.
Chicago, IL 60629

Phone

(773) 776-6666

NPI assigned

Oct 15, 2009

Last updated

Oct 15, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Firas El-Muqdad

Title

President

Phone

(773) 776-6666

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1255564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255564800000",
    "number": "1902131444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2902 W 63RD ST.",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2902 W 63RD ST.",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60629",
            "telephone_number": "773-776-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SHINE III P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-15",
        "last_updated": "2009-10-15",
        "status": "A",
        "authorized_official_last_name": "EL-MUQDAD",
        "authorized_official_first_name": "FIRAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-776-6666"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019026154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Starz LLC
• Dental Starz, LLC
• Dental Sunshine
• Dental Surgery Services, P.C.

• Dental Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.