Westgrove Dental Center

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019027777 Issued in IL

Legal business name

WESTGROVE DENTAL CENTER

Practice address

519 N Cass Ave Ste 102
Westmont, IL 60559-1514

Phone

(630) 389-0006

Fax

(630) 442-7216

NPI assigned

Sep 23, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Laura Funke

Title

Office Manager

Phone

(630) 389-0006

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1379894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379894400000",
    "number": "1093141053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 N CASS AVE STE 102",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591514",
            "telephone_number": "630-389-0006",
            "fax_number": "630-442-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 N CASS AVE STE 102",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591514",
            "telephone_number": "630-389-0006",
            "fax_number": "630-442-7216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTGROVE DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-23",
        "last_updated": "2013-09-23",
        "status": "A",
        "authorized_official_last_name": "FUNKE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "630-389-0006",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019027777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Westmont, IL
• Providers in Westmont, 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 Sep 23, 2013; 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.