CITY KIDS DENTAL, PC (NPI# 1013068972) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013068972 |
| Entity Type | Organization |
| Organization Name | CITY KIDS DENTAL, PC |
| Practice Address |
4700 N Western Ave Suite 1a Chicago IL 60625-2081 |
| Practice Telephone | 7732932700 |
| Practice Fax Number | 7732933854 |
| Mailing Telephone | 7732932700 |
| Mailing Fax Number | 7732933854 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MARY ELIZABETH TIERNEY (PRESIDENT) |
| Authorized Official Telephone | 7732932700 |
| Authorized Official Credential | D.D.S., M.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
IL | Dental Providers |
| Street Address |
4700 N WESTERN AVE SUITE 1A |
| City | CHICAGO |
| State | IL |
| Zip Code | 60625-2081 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649321803 | Mary Elizabeth Tierney | Dentist | 4700 N Western Ave, Suite 1a, Chicago, IL 60625-2081 | 2007-01-15 |
| 1558490433 | Jack N Powitz | Psychiatry & Neurology | 4700 N Western Ave, Ste. 1b, Chicago, IL 60625-2081 | 2007-03-05 |
| 1144366907 | Care Advocate Psychiatric Management, Inc. | Psychiatry & Neurology | 4700 N Western Ave, Ste. 1b, Chicago, IL 60625-2081 | 2007-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134726615 | B Wise Rehabilitation Pllc | Physical Therapist | 4754 N Lincoln Ave, Fl 1, Chicago, IL 60625 | 2020-10-07 |
| 1700490448 | Anita Saini | Pharmacist | 5140 N California Ave, Chicago, Il 60625, Chicago, IL 60625 | 2020-09-01 |
| 1699303164 | Marina Karamanis | Student in an Organized Health Care Education/Training Program | Swedish Hospital, 5140 N. California Ave, Chicago, IL 60625 | 2020-03-31 |
| 1063050227 | Jacqueline Guadalupe Saldana | Behavioral Analyst | 8616 W Catalpa Ave, Suite 1106, Chicago, IL 60625 | 2019-12-18 |
| 1912557802 | Six Senses Therapy LLC | Social Worker | 2334 W. Lawrence Avenue, Suite 204c, Chicago, IL 60625 | 2019-09-13 |
| 1982266110 | Noreen Randhawa | Family Medicine | Swedish Hospital Part of North Shore, 5145 N. California Ave., Chicago, IL 60625 | 2019-07-09 |
| 1376102202 | Nita Gupta | Student in an Organized Health Care Education/Training Program | Graduate Medical Education Department, 5145 N. California Ave, Chicago, IL 60625 | 2019-06-13 |
| 1841763471 | Alexandra Taskier | Counselor | 5359 N Bowmanville Ave., Chicago, IL 60625 | 2019-01-07 |
| 1013490143 | Paula Bielnicka | Pharmacist | Swedish Covenant Hospital - Pharmacy, 5140 N California Ave, Chicago, IL 60625 | 2018-09-14 |
| 1902397078 | Rebecca Abraham | Hospitalist | 5145 N California Ave Ofc M331, Chicago, IL 60625 | 2018-05-24 |
| Find all providers in zip 60625 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528562253 | Rachel Vorwaller | Dentist | 1460 N Halsted St Ste 403, Chicago, IL 60642-2607 | 2018-03-19 |
| 1316393390 | Erin Marie Petrik | Dentist | 2530 N Clark St, Apt 203, Chicago, IL 60614-4972 | 2016-05-10 |
| 1720468598 | Mehedia Haque | Dentist | 2062 N Milwaukee Ave, Chicago, IL 60647 | 2015-06-05 |
| 1811300437 | Michaella Radich Heitzler | Dentist | 1611 N. Wolcott Ave, Chicago, IL 60622 | 2014-06-11 |
| 1356768030 | Esther Levine Pincus | Dentist | Chicago Dental Professionals, 2340 North Clybourn Avenue, Chicago, IL 60614 | 2014-03-19 |
| 1316382187 | Serena Mitchual | Dentist | 801 S Paulina St Rm 256, Chicago, IL 60612-7210 | 2013-05-07 |
| 1962790428 | Megan Davenport | Dentist | 1611 N. Wolcott Ave., Chicago, IL 60622-1362 | 2011-07-19 |
| 1295968121 | Smile Lee Faces | Dentist | 4197 S Archer Ave, Chicago, IL 60632 | 2009-08-26 |
| 1013147024 | Yummy Dental | Dentist | 3500 N Lincoln Ave, Chicago, IL 60657-1104 | 2009-07-24 |
| 1659513950 | Melissa Marie Connell | Dentist | 1611 Wolcott Ave., Chicago, IL 60622 | 2009-04-01 |
| 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.