NPIMap

Organization Active NPI

Procare Dental Group, P.C.

Doing business as BooneCreek Dentistry

  • Dentist
  • McHenry, IL
National Provider Identifier
1245304450
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PROCARE DENTAL GROUP, P.C.
Doing business as
BooneCreek Dentistry
Practice address
5404 W Elm St
Ste F
McHenry, IL 60050-4052
Phone
(815) 759-0871
Fax
(815) 759-0875
NPI assigned
Nov 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robert G Brunetti, D.D.S.NPI 1033341615
Title
Ceo
Phone
(847) 640-1112

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X IL Primary

Addresses

Primary practice location

5404 W Elm St
Ste F
McHenry, IL 60050-4052

Mailing address

605 E Algonquin Rd
Ste 300
Arlington Heights, IL 60005-4373
Phone (847) 640-1112

Other names 1

  • BooneCreek Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Procare Dental Group PC15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

5404 W Elm St
Ste F
McHenry, IL 60050
Phone (815) 759-0871

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245304450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 E ALGONQUIN RD",
            "address_2": "STE 300",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600054373",
            "telephone_number": "847-640-1112",
            "fax_number": "847-640-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5404 W ELM ST",
            "address_2": "STE F",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600504052",
            "telephone_number": "815-759-0871",
            "fax_number": "815-759-0875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCARE DENTAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRUNETTI",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "847-640-1112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BooneCreek Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McHenry, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.