NPIMap

Organization Active NPI

Risorius Dental LLC

Doing business as Risorius Dental

  • Dentist
  • Morton Grove, IL
National Provider Identifier
1275933046
Registry record updated Aug 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019028082 Issued in IL
Legal business name
RISORIUS DENTAL LLC
Doing business as
Risorius Dental
Practice address
9211 Waukegan Rd
Morton Grove, IL 60053-2102
Phone
(847) 965-9211
Fax
(847) 583-9211
NPI assigned
Aug 29, 2014
Last updated
Aug 29, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2014

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

Authorized official

Name
Dr. Vlad Botezatu, DMD
Title
Dentist Owner
Phone
(847) 965-9211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019028082 IL Primary

Addresses

Primary practice location

9211 Waukegan Rd
Morton Grove, IL 60053-2102

Mailing address

9211 Waukegan Rd
Morton Grove, IL 60053-2102
Phone (847) 965-9211

Other names 1

  • Risorius Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Risorius Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409270400000",
    "number": "1275933046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9211 WAUKEGAN RD",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600532102",
            "telephone_number": "847-965-9211",
            "fax_number": "847-583-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9211 WAUKEGAN RD",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600532102",
            "telephone_number": "847-965-9211",
            "fax_number": "847-583-9211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISORIUS DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-29",
        "last_updated": "2014-08-29",
        "status": "A",
        "authorized_official_last_name": "BOTEZATU",
        "authorized_official_first_name": "VLAD",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "847-965-9211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019028082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Risorius Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Morton Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; 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.