Brown Archer Dental PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019025135 Issued in IL

Legal business name

BROWN ARCHER DENTAL PC

Practice address

4893 S Archer Ave
Chicago, IL 60632

Phone

(773) 788-9090

NPI assigned

Aug 29, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Khalil Takla

Title

President

Phone

(773) 788-9090

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Smile Dental Care Doing business as

Locations

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

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1982121042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4893 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606323621",
            "telephone_number": "773-788-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4893 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60632",
            "telephone_number": "773-788-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWN ARCHER DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TAKLA",
        "authorized_official_first_name": "KHALIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-788-9090",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306916465",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Smile Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katrina I Brow, AU.D.
• Mary H Brow, APN
• Jenna Browder, LMT
• Andrew J Brower
• Brown & Schwartz Psychology LLC
• Brown Consulting Services, Inc.
• Keona Ashawnti Brown Goodson, APN
• Brown Health Care Solutions LLC
• Romonia Brown-Coombs
• Linda Brown-Jackson

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.