Abc Dental PC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

19026509 Issued in IL

Legal business name

ABC DENTAL PC

Practice address

4608 W Diversey Ave
Chicago, IL 60639-1801

Phone

(312) 919-6266

NPI assigned

Apr 28, 2015

Last updated

Apr 28, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nada Zayzafoon

Title

Owner

Phone

(312) 919-6266

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1430179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430179200000",
    "number": "1982081055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4608 W DIVERSEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391801",
            "telephone_number": "312-919-6266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4608 W DIVERSEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391801",
            "telephone_number": "312-919-6266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABC DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-28",
        "last_updated": "2015-04-28",
        "status": "A",
        "authorized_official_last_name": "ZAYZAFOON",
        "authorized_official_first_name": "NADA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-919-6266"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "IL",
            "license": "19026509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elham Abboud, MD
• Ghassan Abboud I
• Sam Abboud
• Samir F Abboud, MD
• Abby Eve Psychotherapy, PLLC
• Abc Home Health Care Incorporated
• Abc Home Health Care, Inc
• Abc Labs
• Abcare Clinics & Services, LTD
• Ariane Abcarian, M.D.

• Preferred Provider Organization in Chicago, IL
• Providers in Chicago, IL by specialty
• Preferred Provider Organization in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2015; 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.