Theodore J Pauly DDS LTD

Primary specialty

DentistTaxonomy code 122300000X

License

19010102 Issued in IL

Legal business name

THEODORE J PAULY DDS LTD

Practice address

1940 W Galena Blvd
Suite 10
Aurora, IL 60506-4483

Phone

(630) 892-8933

Fax

(630) 892-8935

NPI assigned

Dec 12, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Theodore John Pauly, DDS

Title

President

Phone

(630) 892-8933

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1134289705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 W GALENA BLVD",
            "address_2": "SUITE 10",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605064483",
            "telephone_number": "630-892-8933",
            "fax_number": "630-892-8935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 W GALENA BLVD",
            "address_2": "SUITE 10",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605064483",
            "telephone_number": "630-892-8933",
            "fax_number": "630-892-8935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEODORE J PAULY DDS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAULY",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-892-8933",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "19010102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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.