NPIMap

Organization Active NPI

Tooth Fairy World PC

  • Pediatric Dentistry
  • Chicago, IL
National Provider Identifier
1922175223
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
TOOTH FAIRY WORLD PC
Practice address
1525 E 55TH Street
#303
Chicago, IL 60615
Phone
(773) 947-8884
Fax
(773) 327-3331
NPI assigned
Nov 29, 2006
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
Marylene Vitiello, DDS
Title
President Corporation
Phone
(773) 947-8884

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X IL Primary

Addresses

Primary practice location

1525 E 55TH Street
#303
Chicago, IL 60615

Mailing address

1525 E 55TH Street
#303
Chicago, IL 60615
Phone (773) 947-8884

National Provider Directory

National Provider Directory
Tax ID family
Tooth Fairy World PC2 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.

Locations

1525 E 55th St
Ste 303
Chicago, IL 60615
Phone (773) 947-9994

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922175223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 E 55TH STREET",
            "address_2": "#303",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60615",
            "telephone_number": "773-947-8884",
            "fax_number": "773-327-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E 55TH STREET",
            "address_2": "#303",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60615",
            "telephone_number": "773-947-8884",
            "fax_number": "773-327-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOOTH FAIRY WORLD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VITIELLO",
        "authorized_official_first_name": "MARYLENE",
        "authorized_official_title_or_position": "PRESIDENT CORPORATION",
        "authorized_official_telephone_number": "773-947-8884",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "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.