International Dental Professionals

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

INTERNATIONAL DENTAL PROFESSIONALS

Practice address

9411 Ackman Rd
Lake in the Hills, IL 60156-9706

Phone

(847) 669-4088

Fax

(847) 669-4018

NPI assigned

Mar 1, 2007

Organization subpart

No

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

Authorized official

Name

Teruyuki Hatakeyama, D.D.S.

Title

President Owner

Phone

(847) 669-4088

Specialties & licenses 1

Addresses

Other names 1

• Lakewood Dental Doing business as

Locations

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104954478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9411 ACKMAN RD",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601569706",
            "telephone_number": "847-669-4088",
            "fax_number": "847-669-4018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9411 ACKMAN RD",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601569706",
            "telephone_number": "847-669-4088",
            "fax_number": "847-669-4018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNATIONAL DENTAL PROFESSIONALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HATAKEYAMA",
        "authorized_official_first_name": "TERUYUKI",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "847-669-4088",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakewood Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Lake in the Hills, IL
• Providers in Lake in the Hills, IL by specialty
• Dentist 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.