Organization Active NPI

Periodontal Implant Specialists

  • Periodontics
  • Oakbrook Terrace, IL
National Provider Identifier
1942455795
Registry record updated Nov 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
021001976 Issued in IL
Legal business name
PERIODONTAL IMPLANT SPECIALISTS
Practice address
17W622 Butterfield Rd
Suite 208
Oakbrook Terrace, IL 60181-4037
Phone
(630) 424-9404
NPI assigned
Nov 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2008

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

Authorized official

Name
Dr. Amarik Singh
Title
Owner/Dr.
Phone
(630) 424-9404

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 021001976 IL Primary

Addresses

Primary practice location

17W622 Butterfield Rd
Suite 208
Oakbrook Terrace, IL 60181-4037

Mailing address

17W622 Butterfield Rd
Suite 208
Oakbrook Terrace, IL 60181-4037
Phone (630) 424-9404

Other identifiers 1

IdentifierTypeStateIssuer
01902446OtherILPERIODONTAL SPECIALIST

National Provider Directory

National Provider Directory

Locations

17W622 Butterfield Rd
Ste 208
Oakbrook Terrace, IL 60181
Phone (630) 424-9404

NPI Registry JSON

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

{
    "created_epoch": "1227139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227139200000",
    "number": "1942455795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17W622 BUTTERFIELD RD",
            "address_2": "SUITE 208",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601814037",
            "telephone_number": "630-424-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17W622 BUTTERFIELD RD",
            "address_2": "SUITE 208",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601814037",
            "telephone_number": "630-424-9404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIODONTAL IMPLANT SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-20",
        "last_updated": "2008-11-20",
        "status": "A",
        "authorized_official_last_name": "SINGH",
        "authorized_official_first_name": "AMARIK",
        "authorized_official_title_or_position": "OWNER/DR.",
        "authorized_official_telephone_number": "630-424-9404",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "021001976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERIODONTAL SPECIALIST",
            "identifier": "01902446",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakbrook Terrace, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; 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.