Organization Active NPI

Katrina Baeverstad DDS LLC

Doing business as In the Loop Dental

  • Dental Clinic/Center
  • Chicago, IL
National Provider Identifier
1043965866
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
KATRINA BAEVERSTAD DDS LLC
Doing business as
In the Loop Dental
Practice address
111 N Wabash Ave Ste 1107
Chicago, IL 60602-3123
Phone
(312) 609-1300
Fax
(312) 609-1306
NPI assigned
Feb 21, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Authorized official

Name
Dr. Katrina Louise Baeverstad, DDS
Title
Dentist
Phone
(312) 609-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

111 N Wabash Ave Ste 1107
Chicago, IL 60602-3123

Mailing address

111 N Wabash Ave Ste 1107
Chicago, IL 60602-3123
Phone (312) 609-1300

Other names 1

  • In the Loop Dental Doing business as

National Provider Directory

National Provider Directory

Locations

111 N Wabash Ave
Ste 1107
Chicago, IL 60602
Phone (312) 609-1300

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645401600000",
    "number": "1043965866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N WABASH AVE STE 1107",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023123",
            "telephone_number": "312-609-1300",
            "fax_number": "312-609-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N WABASH AVE STE 1107",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023123",
            "telephone_number": "312-609-1300",
            "fax_number": "312-609-1306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATRINA BAEVERSTAD DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-21",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A",
        "authorized_official_last_name": "BAEVERSTAD",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "312-609-1300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "In the Loop Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; 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.