Petty & Dragstrem Orthodontics, LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

248001868 Issued in IL

Legal business name

PETTY & DRAGSTREM ORTHODONTICS, LLC

Practice address

5455 Wolf Rd
Western Springs, IL 60558-1853

Phone

(708) 246-4000

NPI assigned

Oct 5, 2017

Organization subpart

No

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

Authorized official

Name

Kristina Dragstrem

Title

Owner

Phone

(708) 246-4000

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.

• Anthony T Young, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Western Springs, IL
  • NPI 1821220344
  NPD (past)

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

{
    "created_epoch": "1507161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1285144154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 WOLF RD",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581853",
            "telephone_number": "708-246-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 WOLF RD",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581853",
            "telephone_number": "708-246-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4230 Westbrook Dr Unit B",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "IL",
            "postal_code": "605044125",
            "country_code": "US",
            "telephone_number": "630-851-6888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PETTY & DRAGSTREM ORTHODONTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-05",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "DRAGSTREM",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-246-4000"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "248001868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunil A Patel, M.D.
• Michael Pawlik
• Matthew David Peahl, DC SC
• Peak Performance
• Patrick Pendleton, D.D.S.
• Joseph P Piento
• Eliot Marshall Pontius
• Michelle Presslak
• Preston Health Partners P C
• Rebecca Cecilia Preston, M.D.

• Orthodontics and Dentofacial Orthopedics Dentistry in Western Springs, IL
• Providers in Western Springs, IL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.