Seretis Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SERETIS DENTAL LLC

Practice address

1501 N State Route 50
Bourbonnais, IL 60914-4429

Phone

(815) 933-7779

NPI assigned

Dec 12, 2017

Last updated

Jun 21, 2023By 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

Thomas Seretis

Title

Owner

Phone

(815) 933-7779

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Bartlomiej D Lakomy, DDS

  • Dentist
  • Bourbonnais, IL
  • NPI 1528683430
  NPD (past)
• Ty Green, DDS

  • Dentist
  • Medina, TN
  • NPI 1851083752
  NPD (past)
• Sarbjit Kaur Thind, D.D.S.

  • Dentist
  • Cincinnati, OH
  • NPI 1861786071

  General Practice

  NPD (past)

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687305600000",
    "number": "1063927176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70887",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441900887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N STATE ROUTE 50",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609144429",
            "telephone_number": "815-933-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERETIS DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-12",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A",
        "authorized_official_last_name": "SERETIS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-933-7779"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Marie Schwarzkopf
• Mary Schweigert, NP-C
• Scott P. Fogel DDS PC
• Emily Rachel Segal, ATR, LCPC
• David Sell
• Michael John Sergeant Sr., M.D.
• Jason L Serpe, DPM
• Ashish Rajesh Shah, M.D.
• Naimi Shah, DDS
• Kimberly B Shelanskey, FNP-BC

• General Practice Dentistry in Bourbonnais, IL
• Providers in Bourbonnais, 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 Jun 21, 2023; 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.