Orland Square Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

019018843 Issued in IL

Legal business name

ORLAND SQUARE DENTAL LLC

Practice address

62 Orland Square Dr Ste 304
Orland Park, IL 60462-6560

Phone

(708) 349-1919

NPI assigned

Feb 12, 2018

Last updated

Feb 12, 2018By 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

Kristy Wolter

Title

Insurance Manager

Phone

(630) 869-5857

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jerome Alan Correa, D.D.S.

  • General Practice Dentistry
  • Orland Park, IL
  • NPI 1750547782
  NPD (past)
• Robert Joseph Doebler, DMD

  • Dentist
  • Orland Park, IL
  • NPI 1750125183
  NPD (past)

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

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518393600000",
    "number": "1134628597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 ORLAND SQUARE DR STE 304",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604626560",
            "telephone_number": "708-349-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 ORLAND SQUARE DR STE 304",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604626560",
            "telephone_number": "708-349-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORLAND SQUARE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-12",
        "last_updated": "2018-02-12",
        "status": "A",
        "authorized_official_last_name": "WOLTER",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "INSURANCE MANAGER",
        "authorized_official_telephone_number": "630-869-5857"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019018843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Orland Premier Dental Inc
• Orland Primary Care Specialists
• Orland School District 135
• Orland Smiles Dental
• Orland Square Dental
• Orland Square Universal Dental LLC
• Orland Square Universal Dental LLC
• Orland Therapy Specialists LTD
• Orland Township
• Orseno Behavioral

• Dental Clinic/Center in Orland Park, IL
• Providers in Orland Park, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; 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.