De Los Reyes Dental LTD.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019-021017 Issued in IL

Legal business name

DE LOS REYES DENTAL LTD.

Practice address

300 N. Milwaukee Avenue
Ste. a
Lake Villa, IL 60046

Phone

(847) 699-2358

Fax

(847) 265-0744

NPI assigned

Aug 24, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Amelia A. De Los Reyes

Title

Office Manager

Phone

(847) 699-2358

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.

• Jose B De Los Reyes, DMD

  • General Practice Dentistry
  • Lake Villa, IL
  • NPI 1376721985
  NPD (past)

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251072000000",
    "number": "1245463371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 188",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "60046",
            "telephone_number": "847-699-2358",
            "fax_number": "847-265-0744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N. MILWAUKEE AVENUE",
            "address_2": "STE. A",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "60046",
            "telephone_number": "847-699-2358",
            "fax_number": "847-265-0744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DE LOS REYES DENTAL LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-24",
        "last_updated": "2009-08-24",
        "status": "A",
        "authorized_official_last_name": "DE LOS REYES",
        "authorized_official_first_name": "AMELIA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "847-699-2358",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-021017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holli Clauser, RBT-17-34670
• Mark J Clauser, RBT
• Sandra Ellen Johnson Clavelli, PSY.D.
• Ricky Joseph Colmer, PHD, LAC.
• Diana Cuna
• Jose B De Los Reyes, DMD
• Kristine Sue Decant, DPT, NCS
• Jigisha Desai, PHARM D
• Jacklyn Louise Durnil, M.S., CCC-SLP
• Kelly Nichole Eckhart, APRN

• General Practice Dentistry in Lake Villa, IL
• Providers in Lake Villa, 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 24, 2009; 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.