Chacon Dental Group

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

019026092 Issued in IL

Legal business name

CHACON DENTAL GROUP

Doing business as

Aurora Orthodontics and Periodontics

Practice address

3535 E New York St
Aurora, IL 60504-4465

Phone

(630) 338-1652

Fax

(630) 689-1358

NPI assigned

Sep 23, 2014

Organization subpart

No

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

Authorized official

Name

Jose Chacon, DDS.MD

Title

Orthodontist

Phone

(630) 338-1658

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Aurora Orthodontics and Periodontics Doing business as

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411430400000",
    "number": "1982006763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 E NEW YORK ST",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605044465",
            "telephone_number": "630-338-1652",
            "fax_number": "630-689-1358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 E NEW YORK ST",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605044465",
            "telephone_number": "630-338-1652",
            "fax_number": "630-689-1358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHACON DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-23",
        "last_updated": "2014-09-23",
        "status": "A",
        "authorized_official_last_name": "CHACON",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "630-338-1658",
        "authorized_official_credential": "DDS.MD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "019026187",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019026092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200384161",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065880272",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aurora Orthodontics and Periodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Central Du Page Hospital Assn
• Cep America - Illinois, LLP
• Cep America Illinois Intensivists
• Noah Cepeda
• Adriana M Cervantes, FNP-BC
• Maria Fernanda Chacon-Horn, MD
• Michelle Chaleco
• Christopher J Chalko, DPT
• Amy Chally, LCSW
• Stephen Chambers, LCPC

• Orthodontics and Dentofacial Orthopedics Dentistry in Aurora, IL
• Providers in Aurora, IL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; 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.