Ravenswood Dental PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

RAVENSWOOD DENTAL PLLC

Practice address

5015 N Paulina St Ste 330
Chicago, IL 60640-2756

Phone

(773) 774-3555

NPI assigned

May 15, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Theodore SiegelNPI 1619166725

Title

Dentist

Phone

(773) 772-8400

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Theodore Michael Siegel, D.D.S.

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1619166725
  NPD Authorized official

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

{
    "created_epoch": "1747267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747267200000",
    "number": "1154112472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 SHERIDAN RD UNIT UL102",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911838",
            "telephone_number": "847-648-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 N PAULINA ST STE 330",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402756",
            "telephone_number": "773-774-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVENSWOOD DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-15",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A",
        "authorized_official_last_name": "SIEGEL",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "773-772-8400",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ravenco Inc
• Paul Anthony Ravenna, M.D.
• Ravenswood Counseling Center
• Ravenswood Counseling Center Co
• Ravenswood Dental Group
• Ravenswood Family Practice
• Ravenswood Health and Wellness Center, S.C.
• Ravenswood Health Center, P.C.
• Ravenswood Pediatrics SC
• Ravenswood Pharmacy Inc

• Dental Clinic/Center in Chicago, IL
• Providers in Chicago, 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 May 15, 2025; 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.