MLB Dental, LTD.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019027066 Issued in IL

Legal business name

MLB DENTAL, LTD.

Practice address

136 S Bolingbrook Dr
Bolingbrook, IL 60440-2852

Phone

(630) 739-5500

NPI assigned

May 16, 2008

Organization subpart

No

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

Authorized official

Name

Marlene Lynn Beeson, D.D.S.

Title

Dentist

Phone

(630) 915-9510

Specialties & licenses 1

Addresses

Tax ID family

MLB Dental LTD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• MLB Dental, LTD.

  • Dentist
  • Forest Park, IL
  • NPI 1366731580
  NPD tax ID

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1124285267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17W230 OAKDALE LN",
            "city": "BENSENVILLE",
            "state": "IL",
            "postal_code": "601062838",
            "telephone_number": "630-915-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 S BOLINGBROOK DR",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402852",
            "telephone_number": "630-739-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MLB DENTAL, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "BEESON",
        "authorized_official_first_name": "MARLENE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "630-915-9510",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019027066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Mitch, DPT
• Donita Mitchell-Gage, CERTIFIED HAIR LOSS
• Tricia L Mitchell, DPT, MPT
• Roopali Mittal, DDS
• Stephen Mizera, PA-C
• Sheik Shafiudeen Mohamed Meerasahib, SURGICAL ASSISTANT
• Mohamed Zaeem Mohamed Thahir
• Miriam De Ocampo Mohammad, RN
• Mushtaq Hussain Mohammed, M.D.
• Ali Maqsood Mohiuddin, M.D.

• General Practice Dentistry in Bolingbrook, IL
• Providers in Bolingbrook, 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 May 16, 2008; 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.