NPIMap

Organization Active NPI

Stony Island Dentalworks LLC

  • Dentist
  • Chicago, IL
National Provider Identifier
1922527852
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19-025166 Issued in IL
Legal business name
STONY ISLAND DENTALWORKS LLC
Practice address
2235 E 71St St
Chicago, IL 60649-2539
Phone
(773) 493-4937
Fax
(773) 675-4419
NPI assigned
Sep 12, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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

Authorized official

Name
Dr. Reginald Torrance Baker, DDSNPI 1134289382
Title
Managing Member
Phone
(773) 493-4937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 19-025166 IL Primary

Addresses

Primary practice location

2235 E 71St St
Chicago, IL 60649-2539

Mailing address

56 E 47TH St Ste 200
Chicago, IL 60653-3982
Phone (773) 858-7481

National Provider Directory

National Provider Directory

Locations

2235 E 71st St
Chicago, IL 60649
Phone (773) 493-4937

56 E 47th St
Ste 200
Chicago, IL 60653

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": "1505174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574035200000",
    "number": "1922527852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 E 47TH ST STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606533982",
            "telephone_number": "773-858-7481",
            "fax_number": "773-675-4419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 E 71ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606492539",
            "telephone_number": "773-493-4937",
            "fax_number": "773-675-4419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONY ISLAND DENTALWORKS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-12",
        "last_updated": "2019-11-18",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_middle_name": "TORRANCE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "773-493-4937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "19-025166",
            "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 Nov 18, 2019; 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.