NPIMap

Organization Active NPI

Gerald L Wine DDS and Daniel L Lassman DDS LTD

Doing business as Division Dental Clinic

  • Dentist
  • Chicago, IL
National Provider Identifier
1922146778
Registry record updated Jul 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
GERALD L WINE DDS AND DANIEL L LASSMAN DDS LTD
Doing business as
Division Dental Clinic
Practice address
2632 W Division St
Chicago, IL 60622-2950
Phone
(773) 235-0980
Fax
(773) 235-1249
NPI assigned
Feb 2, 2007
Last updated
Jul 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2015

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

Authorized official

Name
Nidza Alicea
Title
Office Manager
Phone
(773) 235-0990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary

Addresses

Primary practice location

2632 W Division St
Chicago, IL 60622-2950

Mailing address

2632 W Division St
Chicago, IL 60622-2950
Phone (773) 235-0980

Other names 1

  • Division Dental Clinic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437004800000",
    "number": "1922146778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2632 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222950",
            "telephone_number": "773-235-0980",
            "fax_number": "773-235-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2632 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222950",
            "telephone_number": "773-235-0980",
            "fax_number": "773-235-1249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERALD L WINE DDS AND DANIEL L LASSMAN DDS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2015-07-16",
        "status": "A",
        "authorized_official_last_name": "ALICEA",
        "authorized_official_first_name": "NIDZA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "773-235-0990"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Division Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 16, 2015; 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.