NPI Code Detail JSON Logo

1649657255 NPI number — MELVIN AND JAZMINE DILLARD DDS, PC

NPI Number: 1649657255
Health Care Provider/Practitioner: MELVIN AND JAZMINE DILLARD DDS, PC

Information about “1649657255” NPI (MELVIN AND JAZMINE DILLARD DDS, PC) exists in 1649657255 in HTML format HTML  |  1649657255 in plain Text format TXT  |  1649657255 in PDF (Portable Document Format) PDF  |  1649657255 in an XML format XML  formats.

NPI Number : 1649657255 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1649657255",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MELVIN AND JAZMINE DILLARD DDS, PC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1964 DEMPSTER ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "EVANSTON",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60202-1016",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1964 DEMPSTER ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "EVANSTON",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60202-1016",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "312-600-8119",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/04/2015",
    "LastUpdateDate": "02/28/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "DILLARD",
    "AuthorizedOfficialFirstName": "MELVIN",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "DOCTOR",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "DDS",
    "AuthorizedOfficialTelephoneNumber": "847-563-4484",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "122300000X",
          "TaxonomyName": "Dentist",
          "LicenseNumber": "019029481",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1223X0400X",
          "TaxonomyName": "Orthodontics and Dentofacial Orthopedics Dentistry",
          "LicenseNumber": "021002650",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.