Tinley Dental Group LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019020163 Issued in IL

Legal business name

TINLEY DENTAL GROUP LLC

Practice address

16860 Oak Park Ave
Suite 202
Tinley Park, IL 60477-2761

Phone

(708) 532-4363

Fax

(708) 532-0549

NPI assigned

Feb 26, 2012

Last updated

Feb 26, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James BeckerNPI 1639384589

Title

Manager

Phone

(708) 532-4363

Specialties & licenses 1

Addresses

Locations

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.

• James Robert Becker, DDS

  • General Practice Dentistry
  • Tinley Park, IL
  • NPI 1639384589
  NPD (past) Authorized official
• Vicki Lynn Becker, D.D.S

  • General Practice Dentistry
  • Tinley Park, IL
  • NPI 1225292857
  NPD (past)

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

{
    "created_epoch": "1330214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330214400000",
    "number": "1063786838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16860 OAK PARK AVE",
            "address_2": "SUITE 202",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772761",
            "telephone_number": "708-532-4363",
            "fax_number": "708-532-0549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16860 OAK PARK AVE",
            "address_2": "SUITE 202",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772761",
            "telephone_number": "708-532-4363",
            "fax_number": "708-532-0549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TINLEY DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-26",
        "last_updated": "2012-02-26",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "708-532-4363"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019020163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Tinley Park, IL
• Providers in Tinley 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 Feb 26, 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.