NPIMap

Organization Active NPI

Lemont Family Dental, LTD

  • Dentist
  • Lemont, IL
National Provider Identifier
1194156844
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019-022298 Issued in IL
Legal business name
LEMONT FAMILY DENTAL, LTD
Practice address
160 E Wend St Ste B
Lemont, IL 60439-2904
Phone
(630) 257-8669
Fax
(630) 257-9255
NPI assigned
Dec 6, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

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

Authorized official

Name
Dr. Jennifer L Splitt-Krull, DDS
Title
President
Phone
(630) 257-8669

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019-022298 IL Primary
Durable Medical Equipment & Medical Supplies 332B00000X 019022298 IL
Customized Equipment (DME) 332BC3200X 019022298 IL

Addresses

Primary practice location

160 E Wend St Ste B
Lemont, IL 60439-2904

Mailing address

160 E Wend St Ste B
Lemont, IL 60439-2904
Phone (630) 257-8669

Other identifiers 1

IdentifierTypeStateIssuer
6987150001OtherILPTAN

National Provider Directory

National Provider Directory
Tax ID family
Lemont Family Dental LTD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1386288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441756800000",
    "number": "1194156844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 E WEND ST STE B",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604392904",
            "telephone_number": "630-257-8669",
            "fax_number": "630-257-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E WEND ST STE B",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604392904",
            "telephone_number": "630-257-8669",
            "fax_number": "630-257-9255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEMONT FAMILY DENTAL, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-06",
        "last_updated": "2015-09-09",
        "status": "A",
        "authorized_official_last_name": "SPLITT-KRULL",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-257-8669",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-022298",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "019022298",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "IL",
            "license": "019022298",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "6987150001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lemont, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; 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.