Georgetown Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019019366 Issued in IL

Legal business name

GEORGETOWN DENTAL LLC

Practice address

7212 Edgebrook LN
Hanover Park, IL 60133-3751

Phone

(630) 837-3700

Fax

(630) 837-3849

NPI assigned

Nov 4, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Kathleen M Hansen, D.D.S.NPI 1609867092

Title

Sole Member

Phone

(630) 837-3700

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kathleen Marie Hansen, DDS

  • Dentist
  • Hanover Park, IL
  • NPI 1609867092
  NPD (past) Authorized official

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

{
    "created_epoch": "1257292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257292800000",
    "number": "1023345568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7212 EDGEBROOK LANE",
            "city": "HANOVER PARK",
            "state": "IL",
            "postal_code": "601333751",
            "telephone_number": "630-837-3700",
            "fax_number": "630-837-3849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7212 EDGEBROOK LN",
            "city": "HANOVER PARK",
            "state": "IL",
            "postal_code": "601333751",
            "telephone_number": "630-837-3700",
            "fax_number": "630-837-3849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGETOWN DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-04",
        "last_updated": "2009-11-04",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "630-837-3700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019019366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Constance Lynn Ford, ED.D.,SLP
• Moira Rachel Ford, RD, LDN
• Valerie Ann Fridlund
• Paul Galiano, PT
• Sheila Varughese George, D.M.D.
• Abbey L Graves, PSY.D.
• Greater Elgin Family Care Center
• Greater Elgin Family Care Center
• Greater Elgin Family Care Center
• Greater Elgin Family Care Center

• General Practice Dentistry in Hanover Park, IL
• Providers in Hanover Park, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2009; 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.