NPIMap

Organization Active NPI

Benjamin Logiudice, DDS, LTD

Doing business as North Shore Oral Surgery and Dental Implant Center

  • Oral and Maxillofacial Surgery (Dentist)
  • Deerfield, IL
National Provider Identifier
1083928964
Registry record updated Aug 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
019025769 Issued in IL
Legal business name
BENJAMIN LOGIUDICE, DDS, LTD
Doing business as
North Shore Oral Surgery and Dental Implant Center
Practice address
720 Osterman Ave
Suite 102
Deerfield, IL 60015-4471
Phone
(847) 945-6700
Fax
(847) 945-6707
NPI assigned
Aug 3, 2010
Last updated
Aug 3, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2010

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

Authorized official

Name
Dr. Benjamin LogiudiceNPI 1255341178
Title
Owner, President
Phone
(847) 945-6700

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
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 019025769 IL Primary

Addresses

Primary practice location

720 Osterman Ave
Suite 102
Deerfield, IL 60015-4471

Mailing address

720 Osterman Ave
Suite 102
Deerfield, IL 60015-4471
Phone (847) 945-6700

Other names 1

  • North Shore Oral Surgery and Dental Implant Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1280793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280793600000",
    "number": "1083928964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 OSTERMAN AVE",
            "address_2": "SUITE 102",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154471",
            "telephone_number": "847-945-6700",
            "fax_number": "847-945-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 OSTERMAN AVE",
            "address_2": "SUITE 102",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154471",
            "telephone_number": "847-945-6700",
            "fax_number": "847-945-6707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENJAMIN LOGIUDICE, DDS, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-03",
        "last_updated": "2010-08-03",
        "status": "A",
        "authorized_official_last_name": "LOGIUDICE",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER, PRESIDENT",
        "authorized_official_telephone_number": "847-945-6700",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019025769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Shore Oral Surgery and Dental Implant Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Deerfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; 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.