DENTAL MAGIC NORTH AVE, INC (NPI# 1104274109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104274109 |
| Entity Type | Organization |
| Organization Name | DENTAL MAGIC NORTH AVE, INC |
| Other Organization Name | DENTAL MAGIC |
| Practice Address |
2500 W North Ave Chicago IL 60647-5202 |
| Practice Telephone | 7733601281 |
| Practice Fax Number | 7733601285 |
| Mailing Telephone | 7733601281 |
| Mailing Fax Number | 7733601285 |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2016-05-31 |
| Authorized Official Name | SAWSAN ASFOUR (OWNER) |
| Authorized Official Telephone | 7733601281 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019024297 | IL | Dental Providers |
| Other Name | Type Code |
|---|---|
| Dental Magic | Doing Business As Name - Organization |
| Street Address |
2500 W NORTH AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60647-5202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568092021 | Harshala Chavan | Dentist | 2500 W North Ave, Chicago, IL 60647-5202 | 2020-01-23 |
| 1689167983 | Nasim Khoshfetrat | Dentist | 2500 W North Ave, Chicago, IL 60647-5202 | 2018-06-11 |
| 1568992733 | Kyle Joseph Fairbanks | Dentist | 2500 W North Ave, Chicago, IL 60647-5202 | 2017-06-19 |
| 1235581711 | D2 Dental of Lansing, P.C. | Dentist | 2500 W North Ave, Chicago, IL 60647-5202 | 2016-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164035879 | Scott Spine and Health LLC | Chiropractor | 2560 W. Armitage Ave, Unit C2, Chicago, IL 60647 | 2020-08-24 |
| 1003424458 | Emily Gleesing | Physical Therapist | 1923 N Western Ave, Chicago, IL 60647 | 2020-07-21 |
| 1699301358 | Marcella Guzman P.C. | Dentist | 3236 W. Fullerton Ave., Chicago, IL 60647 | 2020-03-13 |
| 1740772342 | Envision Unlimited | Case Management | 2646 N Washtenaw Ave # 3n, Chicago, IL 60647 | 2018-05-31 |
| 1992297535 | Envision Unlimited | Case Management | 2646 N Washtenaw Ave # 2n, Chicago, IL 60647 | 2018-05-30 |
| 1942704580 | Team Rehabilitation Il15, LLC | Physical Therapist | 1923 N Western Avenue, Chicago, IL 60647 | 2018-03-20 |
| 1023517331 | Chicago Medical Healthcare Group, S.c. | Family Medicine | 3648 W Armitage Avenue, Chicago, IL 60647 | 2018-02-02 |
| 1023537693 | Erin Frommeyer | Physician Assistant | 2228 W Dickens Avenue, Chicago, IL 60647 | 2017-09-15 |
| 1457872475 | Stefanie Paola Maurtua | Behavioral Analyst | 2448 West Bloomingdale Ave., Apt 2e, Chicago, IL 60647 | 2017-06-29 |
| 1700322922 | Lumen Optical Illinois 4, LLC | Optometrist | 2420 N Elston, Bucktown, IL 60647 | 2017-01-11 |
| Find all providers in zip 60647 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295340628 | Karina Valentin | Dentist | 1534 N Oakley Blvd Apt 3f, Chicago, IL 60622-1783 | 2020-09-11 |
| 1679181895 | Robert J Chacon | Dentist | 15 S Throop St Apt 206, Chicago, IL 60607-2522 | 2020-07-14 |
| 1629693304 | Priyanka Sikka | Dentist | 300 W Grand Ave Apt 303, Chicago, IL 60654-7855 | 2020-06-09 |
| 1164045456 | Yong Chang Dds PC. | Dentist | 3531 N Western Ave Unit B, Chicago, IL 60618-6025 | 2020-05-21 |
| 1699301358 | Marcella Guzman P.C. | Dentist | 3236 W. Fullerton Ave., Chicago, IL 60647 | 2020-03-13 |
| 1831749944 | Kenwood Dental Group | Dentist | 1335 E 87th St Ste A, Chicago, IL 60619-7036 | 2019-09-19 |
| 1508412875 | Kamal Paresh Patel | Dentist | 1040 W Randolph St, Chicago, IL 60607-2215 | 2019-08-13 |
| 1003469636 | Ahmed Mansour | Dentist | 2122 N Milwaukee Ave Ste 1, Chicago, IL 60647-4251 | 2019-07-23 |
| 1568024925 | John Michael Burnheimer II | Dentist | 11 S Green St Unit 1106, Chicago, IL 60607-1031 | 2019-07-05 |
| 1497317515 | Prasanth Dommaraju | Dentist | 3924 S Archer Ave, Chicago, IL 60632-1116 | 2019-06-29 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.