Organization Active NPI

Sweet Tooth Doc LTD

Doing business as Sweet Tooth Dentistry

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1952058257
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SWEET TOOTH DOC LTD
Doing business as
Sweet Tooth Dentistry
Practice address
2454 N Ashland Ave
Chicago, IL 60614-2021
Phone
(773) 525-7725
NPI assigned
Mar 7, 2022
Last updated
Mar 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Authorized official

Name
Dr. Margaux Derosset-Grason, DMD
Title
Owner
Phone
(773) 525-7725

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

2454 N Ashland Ave
Chicago, IL 60614-2021

Mailing address

2454 N Ashland Ave
Chicago, IL 60614-2021
Phone (773) 525-7725

Other names 1

  • Sweet Tooth Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

2454 N Ashland Ave
Chicago, IL 60614
Phone (773) 525-7725

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": "1646611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646611200000",
    "number": "1952058257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2454 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606142021",
            "telephone_number": "773-525-7725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2454 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606142021",
            "telephone_number": "773-525-7725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWEET TOOTH DOC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A",
        "authorized_official_last_name": "DEROSSET-GRASON",
        "authorized_official_first_name": "MARGAUX",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-525-7725",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sweet Tooth Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 7, 2022; 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.