Bruce Carl Teipel, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

1915756 Issued in IL

Practice address

95 W Grand Ave
Suite 212
Lake Villa, IL 60046

Phone

(847) 356-2336

Fax

(847) 356-3295

NPI assigned

Apr 25, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235358508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 W GRAND AVE",
            "address_2": "SUITE 212",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "60046",
            "telephone_number": "847-356-2336",
            "fax_number": "847-356-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 W GRAND AVE",
            "address_2": "SUITE 212",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "60046",
            "telephone_number": "847-356-2336",
            "fax_number": "847-356-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEIPEL",
        "first_name": "BRUCE",
        "middle_name": "CARL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "1915756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eevon Swilley, LSW
• Patricia Ann Taglione, PSY. D.
• Shela Tan-Urdaneta
• Junne Tarnorutskiy, LSW
• Francesca Taylor
• Michael Paul Teluk, DDS
• Lindsey Noelle Terning, NP
• The Therapy Tree D.B.a. Birth to Three & Beyond Pediatric Therapies
• Lauren Thompson, SLP
• Tiana Lynn Torres, D.C.

• Dentist in Lake Villa, IL
• Providers in Lake Villa, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.