NPIMap

Organization Active NPI

Lisle Dental Center P.C.

Doing business as Lisle Dental Center

  • General Practice Dentistry
  • Lisle, IL
National Provider Identifier
1215100508
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LISLE DENTAL CENTER P.C.
Doing business as
Lisle Dental Center
Practice address
4712 Main St
Lisle, IL 60532-1749
Phone
(630) 964-0944
NPI assigned
Apr 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Authorized official

Name
Dr. Sumeet Bagai, DDS
Title
President
Phone
(773) 368-1920

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X IL Primary

Addresses

Primary practice location

4712 Main St
Lisle, IL 60532-1749

Mailing address

4712 Main St
Lisle, IL 60532-1749
Phone (630) 964-0944

Other names 1

  • Lisle Dental Center Doing business as

National Provider Directory

National Provider Directory

Locations

4712 Main St
Lisle, IL 60532
Phone (630) 964-0944

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1215100508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4712 MAIN ST",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321749",
            "telephone_number": "630-964-0944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4712 MAIN ST",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321749",
            "telephone_number": "630-964-0944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISLE DENTAL CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "BAGAI",
        "authorized_official_first_name": "SUMEET",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-368-1920",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lisle Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.