NPIMap

Organization Active NPI

Irving Park Family Dentist

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1942595442
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019024678 Issued in IL
Legal business name
IRVING PARK FAMILY DENTIST
Practice address
3435 W Irving Park Rd
Chicago, IL 60618-3217
Phone
(773) 588-8200
Fax
(773) 588-8208
NPI assigned
Jun 13, 2011
Last updated
Oct 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Authorized official

Name
Ivana Bueno
Title
Director of Corporate Operations
Phone
(773) 798-9382

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019024678 IL Primary

Addresses

Primary practice location

3435 W Irving Park Rd
Chicago, IL 60618-3217

Mailing address

3435 W Irving Park Rd
Chicago, IL 60618-3217
Phone (773) 588-8200

National Provider Directory

National Provider Directory

Locations

3431 W Irving Park Rd
Chicago, IL 60618

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760313600000",
    "number": "1942595442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183217",
            "telephone_number": "773-588-8200",
            "fax_number": "773-588-8208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183217",
            "telephone_number": "773-588-8200",
            "fax_number": "773-588-8208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRVING PARK FAMILY DENTIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-13",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A",
        "authorized_official_last_name": "BUENO",
        "authorized_official_first_name": "IVANA",
        "authorized_official_title_or_position": "DIRECTOR OF CORPORATE OPERATIONS",
        "authorized_official_telephone_number": "773-798-9382"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019024678",
            "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 Oct 13, 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.