Dental 360 Mundelein II LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DENTAL 360 MUNDELEIN II LLC

Practice address

714 S Butterfield Rd
Mundelein, IL 60060-9458

Phone

(847) 362-6099

NPI assigned

Nov 15, 2022

Last updated

Sep 5, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Ivana Bueno

Title

Director

Phone

(847) 362-6099

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693872000000",
    "number": "1255040598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 S BUTTERFIELD RD",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600609458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 S BUTTERFIELD RD",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600609458",
            "telephone_number": "847-362-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL 360 MUNDELEIN II LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-15",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A",
        "authorized_official_last_name": "BUENO",
        "authorized_official_first_name": "IVANA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "847-362-6099",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.