<Unavail>
LBN: Chacon Dental Group
<Unavail> is an health care organization with primary practice located at 3535 E New York St , Aurora IL 60504-4465. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / Periodontics, Dental Providers / Orthodontics and Dentofacial Orthopedics. Dental Providers / Orthodontics and Dentofacial Orthopedics is the primary health care specialty.
Chacon Dental Group can be contacted via phone (630) 338-1652, or through Chacon, Jose via phone (630) 338-1658.
Contact Information
Primary practice address
3535 E New York St
Aurora IL 60504-4465
Phone: (630) 338-1652
Fax: (630) 689-1358
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Periodontics | 1223P0300X | 019026187 | Illinois |
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 019026092 | Illinois |
Profile Details
| NPI number | 1982006763 |
|---|---|
| LBN Legal business name | Chacon Dental Group |
| DBA Doing business as | <Unavail> |
| Authorized official | Chacon, Jose DDS.MD |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 23rd, 2014 |
| Last updated | Sep 23rd, 2014 - about 12 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982006763 | NPPES |
| Illinois | MEDICAID | 200384161 | |
| Illinois | MEDICAID | 065880272 |
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