NPIMap

Organization Active NPI

New Smile Center

  • Dentist
  • Chicago, IL
National Provider Identifier
1962653980
Registry record updated Oct 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019-024853 Issued in IL
Legal business name
NEW SMILE CENTER
Practice address
4635 W. 63Rd Street
Suite D
Chicago, IL 60629
Phone
(773) 735-7730
NPI assigned
Oct 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2008

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

Authorized official

Name
Lina Poskus, DDSNPI 1891866695
Title
DDS General Dentist
Phone
(773) 735-7730

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 019-024853 IL Primary

Addresses

Primary practice location

4635 W. 63Rd Street
Suite D
Chicago, IL 60629

Mailing address

4635 W. 63Rd Street
Suite D
Chicago, IL 60629

Other identifiers 1

IdentifierTypeStateIssuer
102597MedicaidIL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224028800000",
    "number": "1962653980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4635 W. 63RD STREET",
            "address_2": "SUITE D",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4635 W. 63RD STREET",
            "address_2": "SUITE D",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60629",
            "telephone_number": "773-735-7730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW SMILE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-08",
        "last_updated": "2008-10-15",
        "status": "A",
        "authorized_official_last_name": "POSKUS",
        "authorized_official_first_name": "LINA",
        "authorized_official_title_or_position": "DDS GENERAL DENTIST",
        "authorized_official_telephone_number": "773-735-7730",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-024853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102597",
            "state": "IL"
        }
    ],
    "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 15, 2008; 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.