Viva Smile Dental PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

VIVA SMILE DENTAL PLLC

Practice address

1504 N Western Ave
Chicago, IL 60622-6614

Phone

(708) 971-3321

NPI assigned

May 9, 2025

Organization subpart

No

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

Authorized official

Name

Omar MoukaddemNPI 1336718659

Title

Managing Partner

Phone

(708) 971-3321

Specialties & licenses 1

Addresses

Practitioners 1

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

• Omar Moukaddem, DMD

  • Dentist
  • Addison, IL
  • NPI 1336718659
  NPD Authorized official

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

{
    "created_epoch": "1746748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746748800000",
    "number": "1942090329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472243",
            "telephone_number": "708-971-3321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 N WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606226614",
            "telephone_number": "708-971-3321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVA SMILE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-09",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A",
        "authorized_official_last_name": "MOUKADDEM",
        "authorized_official_first_name": "OMAR",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "708-971-3321"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haley Vitucci
• Dolores Ann Vitullo, MD
• Marguerite C. Vitulski, APN-CNP
• Serena Viturawong, MD
• Viva Advanced Healthcare Illinois
• Julie L Vivanco, FNP-BC
• Paulina Vivanco, COTA/L
• Vivant Counseling & Psychotherapy, PLLC
• Karina La'O Vivar, MD
• Victoria Diane Viveen, PA-C

• Dental Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; 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.