Organization Active NPI

Love Dental, Inc

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1144540782
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019023707 Issued in IL
Legal business name
LOVE DENTAL, INC
Practice address
11139 S Halsted St
Chicago, IL 60628-3910
Phone
(773) 568-1600
Fax
(773) 568-1603
NPI assigned
Jun 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

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

Authorized official

Name
Dr. Brenda Jean Taylor, D.M.D.
Title
Dentist/Owner
Phone
(773) 568-1600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019023707 IL Primary

Addresses

Primary practice location

11139 S Halsted St
Chicago, IL 60628-3910

Mailing address

11139 S Halsted St
Chicago, IL 60628-3910
Phone (773) 568-1600

Other identifiers 2

IdentifierTypeStateIssuer
1144540782MedicaidIL
019023707MedicaidIL

National Provider Directory

National Provider Directory

Locations

11139 S Halsted St
Chicago, IL 60628
Phone (773) 568-1600

NPI Registry JSON

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

{
    "created_epoch": "1275782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476057600000",
    "number": "1144540782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11139 S HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606283910",
            "telephone_number": "773-568-1600",
            "fax_number": "773-568-1603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11139 S HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606283910",
            "telephone_number": "773-568-1600",
            "fax_number": "773-568-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOVE DENTAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-06",
        "last_updated": "2016-10-10",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "773-568-1600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019023707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144540782",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019023707",
            "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 Oct 10, 2016; 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.