NPIMap

Organization Active NPI

Procare Dental Group, P.C.

  • Dentist
  • Gurnee, IL
National Provider Identifier
1124185467
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PROCARE DENTAL GROUP, P.C.
Practice address
5445 Grand Ave
Ste 202
Gurnee, IL 60031-1725
Phone
(847) 244-2775
Fax
(847) 244-2777
NPI assigned
Jan 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robert G. Brunetti, D.D.S.
Title
C.E.O.
Phone
(847) 640-1112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X IL Primary

Addresses

Primary practice location

5445 Grand Ave
Ste 202
Gurnee, IL 60031-1725

Mailing address

605 E Algonquin Rd
Ste 300
Arlington Heights, IL 60005-4373
Phone (847) 640-1112

Other names 1

  • Grand Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Procare Dental Group PC15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

5445 Grand Ave
Ste 202
Gurnee, IL 60031
Phone (847) 244-2775

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124185467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 E ALGONQUIN RD",
            "address_2": "STE 300",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600054373",
            "telephone_number": "847-640-1112",
            "fax_number": "847-640-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5445 GRAND AVE",
            "address_2": "STE 202",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600311725",
            "telephone_number": "847-244-2775",
            "fax_number": "847-244-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCARE DENTAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRUNETTI",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "847-640-1112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gurnee, IL

Sources for this page

  • 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.