Dr. Tina Khoury, D.M.D., P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019030368 Issued in IL

Legal business name

DR. TINA KHOURY, D.M.D., P.C.

Practice address

50 Lakeview Pkwy Ste 120
Vernon Hills, IL 60061-1590

Phone

(309) 360-8440

NPI assigned

May 20, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Tina Marie Khoury, DMDNPI 1619343688

Title

Owner/Dentist

Phone

(309) 360-8440

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.

• Tina Khoury, DMD

  • General Practice Dentistry
  • Gurnee, IL
  • NPI 1619343688
  NPD Authorized official

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597363200000",
    "number": "1205283165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 TIGER LILY LN",
            "address_2": "APT 404",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600319639",
            "telephone_number": "309-360-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 LAKEVIEW PKWY STE 120",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611590",
            "telephone_number": "309-360-8440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "355 Greenleaf St",
            "address_purpose": "LOCATION",
            "city": "Park City",
            "state": "IL",
            "postal_code": "600855708",
            "country_code": "US",
            "telephone_number": "847-930-5824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DR. TINA KHOURY, D.M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-20",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A",
        "authorized_official_last_name": "KHOURY",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "309-360-8440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019030368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Vernon Hills, IL
• Providers in Vernon Hills, 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 Aug 14, 2020; 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.