Northwest Implant Dental Spa

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

NORTHWEST IMPLANT DENTAL SPA

Practice address

109 N Milwaukee Ave
Wheeling, IL 60090-3013

Phone

(847) 541-3434

NPI assigned

Mar 6, 2017

Organization subpart

No

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

Authorized official

Name

Daniel KimNPI 1457588378

Title

Owner

Phone

(847) 541-3434

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel Y Kim, D.D.S.

  • Dentist
  • Chicago, IL
  • NPI 1457588378
  NPD (past) Authorized official

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

{
    "created_epoch": "1488758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488758400000",
    "number": "1922548270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 N MILWAUKEE AVE",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600903013",
            "telephone_number": "847-541-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N MILWAUKEE AVE",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600903013",
            "telephone_number": "847-541-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST IMPLANT DENTAL SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-06",
        "last_updated": "2017-03-06",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-541-3434"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Wheeling, IL
• Providers in Wheeling, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2017; 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.