NPIMap

Organization Active NPI

Eugene Merbaum DDS PC

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1962675413
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
EUGENE MERBAUM DDS PC
Practice address
3201 South Wallace St
Chicago, IL 60616-3501
Phone
(312) 842-7846
Fax
(312) 842-8340
NPI assigned
Apr 4, 2008
Last updated
Apr 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2008

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

Authorized official

Name
Dr. Eugene Merbaum, DDSNPI 1508976929
Title
President
Phone
(312) 842-7846

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

3201 South Wallace St
Chicago, IL 60616-3501

Mailing address

3201 South Wallace St
Chicago, IL 60616-3501
Phone (312) 842-7846

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, 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": "1207267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207267200000",
    "number": "1962675413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 SOUTH WALLACE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163501",
            "telephone_number": "312-842-7846",
            "fax_number": "312-842-8340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 SOUTH WALLACE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163501",
            "telephone_number": "312-842-7846",
            "fax_number": "312-842-8340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUGENE MERBAUM DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-04",
        "last_updated": "2008-04-04",
        "status": "A",
        "authorized_official_last_name": "MERBAUM",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-842-7846",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "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 Apr 4, 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.