DOVER DENTAL CENTER NPI 1003449018

Dentist (General Practice) in Aurora, IL

Organization Dentist General Practice

About DOVER DENTAL CENTER

Dover Dental Center is a provider established in Aurora, Illinois specializing in dentist. The NPI number of Dover Dental Center is 1003449018 and was assigned on February 2020. The practitioner's primary taxonomy code is 1223G0001X. The provider is registered as an organization and their NPI record was last updated March 2020. The authorized official of this NPI record is Dr. Maryam Hafezi Dmd (General Dentist)

NPI

1003449018

Provider NameDOVER DENTAL CENTER
Provider Location Address95 TRADE ST STE 101 AURORA, IL 60504
Provider Mailing Address95 TRADE ST STE 101 AURORA, IL 60504
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date02-18-2020
Last Update Date03-02-2020

Primary Taxonomy

Taxonomy Code1223G0001X
ClassificationDentist
TypeDental Providers
SpecializationGeneral Practice
Taxonomy DescriptionA 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.

Business Address

DOVER DENTAL CENTER
95 TRADE ST STE 101
AURORA, IL
ZIP 60504
Phone: (630) 851-7878

Get Directions

Mailing Address

DOVER DENTAL CENTER
95 TRADE ST STE 101
AURORA, IL
ZIP 60504
Phone:

Authorized Official

Authorized Official NameDR. MARYAM HAFEZI DMD
Authorized Official TitleGENERAL DENTIST
Authorized Official Phone(630) 851-7878

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalNo

Taxonomy Description:

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
019025427MEDICAID (05)IL

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.