NPIMap

Organization Active NPI

K Chan Dental, P.C.

Doing business as North Shore Artistic Dentistry

  • General Practice Dentistry
  • Northfield, IL
National Provider Identifier
1942640743
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019027662 Issued in IL
Legal business name
K CHAN DENTAL, P.C.
Doing business as
North Shore Artistic Dentistry
Practice address
310 Happ Rd
Suite 208
Northfield, IL 60093-3455
Phone
(847) 501-2882
Fax
(847) 501-2883
NPI assigned
Jun 26, 2013
Last updated
Jun 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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

Authorized official

Name
Dr. William Brian Ross, D.D.S.
Title
President
Phone
(847) 501-2882

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 019027662 IL Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 019016908 IL
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 019028001 IL
Dental HygienistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 124Q00000X 020007283 IL

Addresses

Primary practice location

310 Happ Rd
Suite 208
Northfield, IL 60093-3455

Mailing address

310 Happ Rd
Suite 208
Northfield, IL 60093-3455
Phone (847) 501-2882

Other names 1

  • North Shore Artistic Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

310 Happ Rd
Ste 208
Northfield, IL 60093
Phone (847) 501-2882

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372204800000",
    "number": "1942640743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 HAPP RD",
            "address_2": "SUITE 208",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933455",
            "telephone_number": "847-501-2882",
            "fax_number": "847-501-2883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 HAPP RD",
            "address_2": "SUITE 208",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933455",
            "telephone_number": "847-501-2882",
            "fax_number": "847-501-2883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K CHAN DENTAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-26",
        "last_updated": "2013-06-26",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-501-2882",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019027662",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019016908",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019028001",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": "IL",
            "license": "020007283",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Shore Artistic Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Northfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; 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.