Organization Active NPI

Lawndale Dental, P.C.

  • Dentist
  • Chicago, IL
National Provider Identifier
1144203605
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
LAWNDALE DENTAL, P.C.
Practice address
3600 W Roosevelt Rd
Chicago, IL 60624-4225
Phone
(773) 638-6890
Fax
(773) 638-6891
NPI assigned
Nov 29, 2005
Last updated
Aug 22, 2020By the provider in NPPES
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. Aroon Pal, DMD
Title
President
Phone
(773) 638-6890

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X IL Primary

Addresses

Primary practice location

3600 W Roosevelt Rd
Chicago, IL 60624-4225

Mailing address

3600 W Roosevelt Rd
Chicago, IL 60624-4225
Phone (773) 638-6890

Other identifiers 1

IdentifierTypeStateIssuer
1005211MedicaidIL

National Provider Directory

National Provider Directory

Locations

3600 W Roosevelt Rd
Chicago, IL 60624
Phone (773) 533-1417

NPI Registry JSON

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144203605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 W ROOSEVELT RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606244225",
            "telephone_number": "773-638-6890",
            "fax_number": "773-638-6891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 W ROOSEVELT RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606244225",
            "telephone_number": "773-638-6890",
            "fax_number": "773-638-6891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWNDALE DENTAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAL",
        "authorized_official_first_name": "AROON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-638-6890",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1005211",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, 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.