NPIMap

Organization Active NPI

Lake Zurich Orthodontics LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lake Zurich, IL
National Provider Identifier
1053665380
Registry record updated Nov 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
021.002483 Issued in IL
Legal business name
LAKE ZURICH ORTHODONTICS LLC
Practice address
545 N. Rand Rd.
Lake Zurich, IL 60047-3134
Phone
(847) 847-7736
Fax
(866) 302-4168
NPI assigned
Nov 8, 2012
Last updated
Nov 8, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2012

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

Authorized official

Name
Dr. Sam Philip Calabrese, DDSNPI 1689837882
Title
Administrator
Phone
(847) 847-7736

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
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 021.002483 IL Primary

Addresses

Primary practice location

545 N. Rand Rd.
Lake Zurich, IL 60047-3134

Mailing address

545 N. Rand Rd.
Lake Zurich, IL 60047-3134
Phone (847) 847-7736

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1352332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352332800000",
    "number": "1053665380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 N. RAND RD.",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600473134",
            "telephone_number": "847-847-7736",
            "fax_number": "866-302-4168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 N. RAND RD.",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600473134",
            "telephone_number": "847-847-7736",
            "fax_number": "866-302-4168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE ZURICH ORTHODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-08",
        "last_updated": "2012-11-08",
        "status": "A",
        "authorized_official_last_name": "CALABRESE",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "PHILIP",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "847-847-7736",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "021.002483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Zurich, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; 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.