NPIMap

Organization Active NPI

Waukegan Family Family

  • General Practice Dentistry
  • Waukegan, IL
National Provider Identifier
1023458502
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019-018637 Issued in IL
Legal business name
WAUKEGAN FAMILY FAMILY
Practice address
338 S. Greenbay Rd.
Waukegan, IL 60085-4850
Phone
(847) 336-7800
NPI assigned
Jun 28, 2013
Last updated
Jun 28, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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

Authorized official

Name
Dr. Michael Papendick, DDSNPI 1801890215
Title
Owner
Phone
(847) 336-7800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019-018637 IL Primary

Addresses

Primary practice location

338 S. Greenbay Rd.
Waukegan, IL 60085-4850

Mailing address

338 S. Greenbay Rd.
Waukegan, IL 60085-4850
Phone (847) 336-7800

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372377600000",
    "number": "1023458502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 S. GREENBAY RD.",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854850",
            "telephone_number": "847-336-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 S. GREENBAY RD.",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854850",
            "telephone_number": "847-336-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAUKEGAN FAMILY FAMILY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-28",
        "last_updated": "2013-06-28",
        "status": "A",
        "authorized_official_last_name": "PAPENDICK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-336-7800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-018637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2013; 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.