Bolingbrook Dental Associates LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BOLINGBROOK DENTAL ASSOCIATES LLC

Practice address

391 Quadrangle Dr
Bolingbrook, IL 60440-3442

Phone

(630) 759-4400

NPI assigned

Jan 22, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Oscar G Gonzalez

Title

Director of Operations

Phone

(219) 465-8627

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548115200000",
    "number": "1003370248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 QUADRANGLE DR",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604403442",
            "telephone_number": "630-759-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 QUADRANGLE DR",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604403442",
            "telephone_number": "630-759-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLINGBROOK DENTAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-22",
        "last_updated": "2019-01-22",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "OSCAR",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "219-465-8627"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Boerst
• Oladunni F Boladale, DNP
• Nicole A Boler, MD
• Katie Bolf, ATC
• Bolingbrook Compounding Pharmacy
• Bolingbrook Dental Care
• Bolingbrook Eye Care & Eyewear Gallery, LLC
• Bolingbrook Eye Specialists LTD
• Bolingbrook Family Chiropractic LTD
• Bolingbrook Foot & Ankle Center, P.C.

• Dental Clinic/Center in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.