Glenlake Dental Care PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

GLENLAKE DENTAL CARE PC

Practice address

946 Harlem Ave
Glenview, IL 60025-4275

Phone

(847) 724-3969

NPI assigned

Mar 27, 2012

Last updated

Mar 27, 2012By 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

Mary Afzali, DDS

Title

President

Phone

(847) 724-3969

Specialties & licenses 3

Addresses

Practitioners 3

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.

• Azadeh Mary Afzali, DDS

  • General Practice Dentistry
  • Glenview, IL
  • NPI 1275796237
  NPD (past)
• Eric Chullwhan Lim, DDS

  • General Practice Dentistry
  • Glenview, IL
  • NPI 1316100365
  NPD (past)
• Anu Ojas Wadivkar, DDS

  • General Practice Dentistry
  • Glenview, IL
  • NPI 1205099264
  NPD (past)

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1184990897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "946 HARLEM AVE",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600254275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "946 HARLEM AVE",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600254275",
            "telephone_number": "847-724-3969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENLAKE DENTAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-27",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "AFZALI",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-724-3969",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glen Ridge Associates II Limited Partnership (The Abingtonof Glenview)
• Glenbrook Family Dental
• Glenbrook Oral & Maxillofacial Surgery LTD
• Glenbrook Pediatrics, S.C.
• Glengrove Dental Associates
• Glenn Counseling Center
• Elizabeth Rebecca Glenn, COTA/L
• Glenview CC SCH Dist 34
• Glenview Counseling Group
• Glenview Dental Associates, LTD

• Dentist in Glenview, IL
• Providers in Glenview, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; 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.