Lakeside Dental Center

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

LAKESIDE DENTAL CENTER

Practice address

2218 S Michigan Ave
Chicago, IL 60616-2126

Phone

(312) 842-7133

Fax

(312) 842-7148

NPI assigned

Apr 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Charles Zelmore Teicher

Title

President

Phone

(312) 842-7133

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104046671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2218 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162126",
            "telephone_number": "312-842-7133",
            "fax_number": "312-842-7148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2218 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162126",
            "telephone_number": "312-842-7133",
            "fax_number": "312-842-7148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TEICHER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "ZELMORE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-842-7133",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakeshore Womens Health Specialists SC
• Lakeshorehealthcare
• Lakeside Community Committee
• Lakeside Community Committee
• Lakeside Dental Center
• Lakeside Dental Center Inc.
• Lakeside Eye Clinic Inc
• Lakeside Eye Group, S.C.
• Lakeside Medical Group LTD
• Lakeside Nephrolgoy LTD/Prarie

• All providers in Chicago, IL
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.