NPIMap

Organization Active NPI

Northwestern Dental Clinic LTD

  • Dentist
  • Chicago, IL
National Provider Identifier
1922248210
Registry record updated Feb 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019023897 Issued in IL
Legal business name
NORTHWESTERN DENTAL CLINIC LTD
Practice address
2604 W North Ave
Chicago, IL 60647-5235
Phone
(773) 252-0033
NPI assigned
Feb 25, 2009
Last updated
Feb 25, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2009

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

Authorized official

Name
Dr. Ali Ektera
Title
President
Phone
(773) 252-0033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019023897 IL Primary

Addresses

Primary practice location

2604 W North Ave
Chicago, IL 60647-5235

Mailing address

2604 W North Ave
Chicago, IL 60647-5235
Phone (773) 252-0033

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235520000000",
    "number": "1922248210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475235",
            "telephone_number": "773-252-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475235",
            "telephone_number": "773-252-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWESTERN DENTAL CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-25",
        "last_updated": "2009-02-25",
        "status": "A",
        "authorized_official_last_name": "EKTERA",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-252-0033",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019023897",
            "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 Feb 25, 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.