Berwyn Dental Group

Primary specialty

DentistTaxonomy code 122300000X

License

019027342 Issued in IL

Legal business name

BERWYN DENTAL GROUP

Practice address

6218 Cermak Rd
Berwyn, IL 60402-2322

Phone

(708) 317-5150

NPI assigned

Apr 15, 2011

Last updated

Apr 15, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Victoriano Avila

Title

DDS

Phone

(708) 317-5150

Specialties & licenses 1

Addresses

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Avila Dental PC

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1235595331
  NPPES parent name

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

{
    "created_epoch": "1302825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302825600000",
    "number": "1942590500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6218 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022322",
            "telephone_number": "708-317-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6218 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022322",
            "telephone_number": "708-317-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERWYN DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-15",
        "last_updated": "2011-04-15",
        "status": "A",
        "authorized_official_last_name": "AVILA",
        "authorized_official_first_name": "VICTORIANO",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "708-317-5150"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Jean Bernardo, DO
• Sheila Anne Berndt, M.D.
• Allen C. Bernthal, M.D.
• John Berry, MD
• Berwyn Dental Clinic
• Berwyn Dental Inc.
• Berwyn Diagnostic Imaging LLC
• Berwyn Emergency Physicians, LLP
• Berwyn Emergency Services SC (Healthstop)
• Berwyn Family Dental

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2011; 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.