NPIMap

University Dental Associates

Organization Active NPI General Practice Dentistry · Chicago, IL

NPI 1962638817 · NPPES record last updated Jun 5, 2009

Key facts

NPI
1962638817
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
019-021911 (IL)
Legal business name
UNIVERSITY DENTAL ASSOCIATES
Practice address
1424 E 53Rd St Ste 28
Suite 209
Chicago, IL 60615-4553
Phone
(773) 363-6009
NPI assigned
Jun 5, 2009
Organization subpart
No

Authorized official

Name
Rajan Sharma
Title
Owner
Phone
(773) 363-6009

Corporate family (same tax ID) 5

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
University Dental Associates (6 organizations share this tax ID)

Locations

1424 E 53rd St
Ste 209
Chicago, IL 60615
Phone (773) 363-6009

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193200000X MULTI-SPECIALTY GROUP		 1223G0001X 019-021911 IL Yes

Addresses

Primary practice location

1424 E 53Rd St Ste 28
Suite 209
Chicago, IL 60615-4553

Mailing address

1424 E 53Rd St Ste 28
Suite 209
Chicago, IL 60615-4553
Phone (773) 363-6009

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 5, 2009.

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244160000000",
    "number": "1962638817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 E 53RD ST STE 28",
            "address_2": "SUITE 209",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154553",
            "telephone_number": "773-363-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 E 53RD ST STE 28",
            "address_2": "SUITE 209",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154553",
            "telephone_number": "773-363-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-05",
        "last_updated": "2009-06-05",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "RAJAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-363-6009"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-021911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

All providers in Chicago, IL · General Practice Dentistry in Illinois

Sources for this page

Verify at the official NPI Registry.