Active NPI
Kaitlyn Lagesse, DMD
- Dentist
- Chicago, IL
National Provider Identifier
1205450509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019.032623
- Practice address
- 1700 N Western Ave
Chicago, IL 60647-5324 - Phone
- (312) 620-7733
- NPI assigned
- Jun 2, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.032623 | IL | Primary |
Addresses
Primary practice location
1700 N Western Ave
Chicago, IL 60647-5324
Mailing address
1700 N Western Ave
Chicago, IL 60647-5324
Phone (312) 620-7733
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019.032623 | Other | IL | STATE OF ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.032623 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777852800000",
"number": "1205450509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 N WESTERN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606475324",
"telephone_number": "312-620-7733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 N WESTERN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606475324",
"telephone_number": "312-620-7733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAGESSE",
"first_name": "KAITLYN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-02",
"last_updated": "2026-05-04",
"certification_date": "2026-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.032623",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION",
"identifier": "019.032623",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.