Crystal Lake Family Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CRYSTAL LAKE FAMILY DENTAL

Practice address

651 W Terra Cotta Ave
Suite 201
Crystal Lake, IL 60014-3404

Phone

(630) 339-3172

Fax

(847) 891-6775

NPI assigned

Jul 1, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Alan J Acierno, D.D.S.

Title

Owner

Phone

(630) 339-3172

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1372636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372636800000",
    "number": "1154761492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 S ROSELLE RD",
            "address_2": "SUITE 102",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601935540",
            "telephone_number": "630-339-3172",
            "fax_number": "847-891-6775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 W TERRA COTTA AVE",
            "address_2": "SUITE 201",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143404",
            "telephone_number": "630-339-3172",
            "fax_number": "847-891-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL LAKE FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-01",
        "last_updated": "2013-07-01",
        "status": "A",
        "authorized_official_last_name": "ACIERNO",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-339-3172",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Crowley
• Crystal Family Dental Care
• Crystal Lake CC SCH Dist 47
• Crystal Lake Center for Chronic Pain SC
• Crystal Lake Dermatology SC
• Crystal Lake Family Treatment Center LTD
• Crystal Lake Family Wellness
• Crystal Lake Foot & Ankle Center LLC
• Crystal Lake Immediate Care Physicians LTD.
• Crystal Lake Medical and Sports Rehab SC

• General Practice Dentistry in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; 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.