BROWN ARCHER DENTAL PC (NPI# 1982121042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982121042 |
| Entity Type | Organization |
| Organization Name | BROWN ARCHER DENTAL PC |
| Other Organization Name | SMILE DENTAL CARE |
| Practice Address |
4893 S Archer Ave Chicago IL 60632 |
| Mailing Address |
4893 S Archer Ave Chicago IL 60632-3621 |
| Practice Telephone | (773) 788-9090 |
| Mailing Telephone | 7737889090 |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2017-09-18 |
| Authorized Official Name | DR. KHALIL TAKLA (PRESIDENT) |
| Authorized Official Telephone | 7737889090 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019025135 | IL | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 1306916465 | 05 |
| Other Name | Type Code |
|---|---|
| Smile Dental Care | Doing Business As Name - Organization |
| Street Address |
4893 S ARCHER AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104474790 | Amanda Rose Dirnberger | Nurse Practitioner | 3229-43 W. 47th Pl., Chicago, IL 60632 | 2019-08-28 |
| 1538577085 | Metrosmiles - Archer Heights Dental | Dentist | 5141 S Cicero Ave, Chicago, IL 60632 | 2014-07-29 |
| 1174955173 | Thresholds | Community/Behavioral Health | 718-24 West 47th St, Chicago, IL 60632 | 2013-08-01 |
| 1659612570 | Sapex Home Healthcare, Inc. | In Home Supportive Care | 4107 West 47th Street, Chicago, IL 60632 | 2013-03-04 |
| 1912275462 | Dawn Marie Mackessy | Pharmacist | 5435 S. Kedzie Ave, Chicago, IL 60632 | 2011-12-12 |
| 1033494752 | Molly Elizabeth Mcdermott | Pharmacist | District 222-walgreens, Chicago, IL 60632 | 2011-10-13 |
| 1780908434 | Chicago Electrical Trauma Research Institute | Specialist/Technologist, Other | 4047 W. 40th Street, Chicago, IL 60632 | 2010-03-24 |
| 1265765218 | 4365 Archer Mri, LLC | Clinic/Center | 4365 South Archer Avenue, Chicago, IL 60632 | 2009-09-09 |
| 1295968121 | Smile Lee Faces | Dentist | 4197 S Archer Ave, Chicago, IL 60632 | 2009-08-26 |
| 1578791158 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 4313 S. Pulaski, Chicago, IL 60632 | 2009-06-23 |
| Find all providers in zip 60632 | ||||
| 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.