NPIMap

Organization Active NPI

Abd Dental Associates, LLC

  • Dentist
  • Bloomingdale, IL
National Provider Identifier
1043752322
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019030560 Issued in IL
Legal business name
ABD DENTAL ASSOCIATES, LLC
Practice address
444 W Army Trail Rd
Bloomingdale, IL 60108-1379
Phone
(630) 387-9764
NPI assigned
Nov 17, 2016
Last updated
Nov 17, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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

Authorized official

Name
Heather Kraushaar
Title
PRS
Phone
(315) 454-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019030560 IL Primary

Addresses

Primary practice location

444 W Army Trail Rd
Bloomingdale, IL 60108-1379

Mailing address

PO Box 3189
Syracuse, NY 13220-3189

National Provider Directory

National Provider Directory

Locations

444 W Army Trail Rd
Bloomingdale, IL 60108
Phone (312) 973-1313

Practitioners & affiliated clinicians

Practitioners 4

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": "1479340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479340800000",
    "number": "1043752322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 W ARMY TRAIL RD",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081379",
            "telephone_number": "630-387-9764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABD DENTAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-17",
        "last_updated": "2016-11-17",
        "status": "A",
        "authorized_official_last_name": "KRAUSHAAR",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "PRS",
        "authorized_official_telephone_number": "315-454-6000"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019030560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; 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.