FAMILY DENTAL OF ROSCOE INC (NPI# 1205285293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205285293 |
| Entity Type | Organization |
| Organization Name | FAMILY DENTAL OF ROSCOE INC |
| Practice Address |
3332 N Western Ave Chicago IL 60618-6213 |
| Practice Telephone | 7736792419 |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2016-06-09 |
| Authorized Official Name | MRS. OLENA OBEID (CEO) |
| Authorized Official Telephone | 7736792419 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
019.028238 | IL | Ambulatory Health Care Facilities |
| Street Address |
3332 N WESTERN AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60618-6213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336398007 | Sharon Sarah Varghese | Dentist | 3332 N Western Ave, Chicago, IL 60618-6213 | 2008-09-17 |
| 1063785806 | Shiny Smiles Inc | Dentist | 3332 N Western Ave, Chicago, IL 60618-6213 | 2012-02-09 |
| 1194012773 | Paul Richard Morrison Jr. | Dentist | 3332 N Western Ave, Chicago, IL 60618-6213 | 2011-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134741622 | Cvs Aoc Services, L.L.C. | Optometrist | 4051 North Lincoln, Store 8751, Chicago, IL 60618 | 2020-05-07 |
| 1699317404 | Joseph Thank Harmon | Registered Nurse | 5645 W Addison, Chicago, IL 60618 | 2019-10-14 |
| 1760952626 | Prep Performance Center, LLC | Clinic/Center | 4022 N Rockwell Street, Chicago, IL 60618 | 2018-12-04 |
| 1528540986 | Ruby Erdmann | Dietitian, Registered | 3126 N Kimball Ave. #3w, Chicago, IL 60618 | 2018-09-02 |
| 1962997064 | Living Roots Psychotherapy, LLC | Clinic/Center | 4310 N Spaulding Ave, Chicago, IL 60618 | 2018-06-30 |
| 1962920116 | Alif Muhammad | Counselor | 3819 W Cornelia Ave #2, Chicago, IL 60618 | 2017-09-07 |
| 1417471178 | Daniel Lee Mcmillan | Counselor | 3433 N. Ridgeway Ave, Apt G, Chicago, IL 60618 | 2017-08-03 |
| 1508380486 | Callie Weinberg | Social Worker | 2945 N Damen Ave, 1s, Chicago, IL 60618 | 2017-08-01 |
| 1275062697 | Melissa Ann Prest | Dietitian, Registered | 3258 W Warner Ave, Apt 2, Chicago, IL 60618 | 2017-06-08 |
| 1871951038 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 4315 N. Lincoln Avenue, Chicago, IL 60618 | 2016-02-03 |
| Find all providers in zip 60618 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629514 | Chicago Pediatric Dentistry and Orthodontics | Clinic/Center | 1136 S Delano Ct W Ste B202, Chicago, IL 60605-3734 | 2020-11-03 |
| 1245858695 | Versiani Dental PC | Clinic/Center | 2340 N California Ave, Chicago, IL 60647-6622 | 2020-07-13 |
| 1710513478 | Ethicadent | Clinic/Center | 6418 W Belmont Ave Ste 101, Chicago, IL 60634-4099 | 2020-03-13 |
| 1558993758 | King Dental, PC | Clinic/Center | 3425 S King Dr, Chicago, IL 60616 | 2020-02-06 |
| 1750912671 | Wicker Park Dental Studio | Clinic/Center | 1282 N Milwaukee Ave, Chicago, IL 60622-9319 | 2020-01-29 |
| 1811535404 | Secure Dental Vi | Clinic/Center | 3540 N Ashland Ave, Chicago, IL 60657-1314 | 2019-12-15 |
| 1154972768 | David K Mayes D.d.s L.t.d. | Clinic/Center | 9101 S Western Ave # 2ndfl, Chicago, IL 60643-6751 | 2019-09-25 |
| 1235787730 | Alta Dental LLC | Clinic/Center | 5892 S Archer Ave, Chicago, IL 60638-1658 | 2019-08-28 |
| 1982257218 | Allure Dental Lincoln Park | Clinic/Center | 558 W Diversey Pkwy, Chicago, IL 60614-1678 | 2019-07-16 |
| 1568026656 | Cjn Loop Dental Ltd | Clinic/Center | 30 N Michigan Ave Ste 622, Chicago, IL 60602-3821 | 2019-04-24 |
| Find all providers in CHICAGO | ||||
Please comment or provide details below to improve the information on FAMILY DENTAL OF ROSCOE INC.
| 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.