River Grove Dental Associates LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019021920 Issued in IL

Legal business name

RIVER GROVE DENTAL ASSOCIATES LLC

Practice address

8225 Grand Ave
River Grove, IL 60171-1517

Phone

(708) 453-1110

NPI assigned

Jul 11, 2010

Last updated

Jul 11, 2010By 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

Dr. Frank Siracusa, DDSNPI 1285721928

Title

Member/ Owner

Phone

(708) 453-1110

Specialties & licenses 1

Addresses

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.

• Frank Siracusa, DDS

  • General Practice Dentistry
  • River Grove, IL
  • NPI 1285721928
  NPD (past) Authorized official
• Gregory Amadeo Bertagna, D.D.S.

  • General Practice Dentistry
  • River Grove, IL
  • NPI 1164439907
  NPD (past)

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

{
    "created_epoch": "1278806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278806400000",
    "number": "1093027658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8225 GRAND AVE",
            "city": "RIVER GROVE",
            "state": "IL",
            "postal_code": "601711517",
            "telephone_number": "708-453-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8225 GRAND AVE",
            "city": "RIVER GROVE",
            "state": "IL",
            "postal_code": "601711517",
            "telephone_number": "708-453-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER GROVE DENTAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-11",
        "last_updated": "2010-07-11",
        "status": "A",
        "authorized_official_last_name": "SIRACUSA",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "MEMBER/ OWNER",
        "authorized_official_telephone_number": "708-453-1110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019021920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Rasums, PT
• Resilience Healthcare- Lakefront Medical Associates, LLC (Chicago Health Medical Group)
• Rest & Relief Chiropractic, LLC
• Rhodes School District 84.5
• River Grove Clinic
• River Grove School District 85.5
• Robert Rutkowski DCPC
• Robert Rutkowski, D.C.
• S. David Demorest
• David Shifman, D.C.

• General Practice Dentistry in River Grove, IL
• Providers in River Grove, 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 Jul 11, 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.