Paul Doodes DDS PHD PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PAUL DOODES DDS PHD PC

Doing business as

Park Blvd Dentistry

Practice address

45 S Park Blvd Ste 190
Glen Ellyn, IL 60137-6282

Phone

(630) 469-0800

Fax

(630) 474-0597

NPI assigned

Oct 15, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Paul David Doodes, DDS PHDNPI 1164782066

Title

Owner

Phone

(630) 765-1709

Specialties & licenses 1

Addresses

Other names 1

• Park Blvd Dentistry Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul David Doodes, D.D.S., PH.D.

  • General Practice Dentistry
  • Glen Ellyn, IL
  • NPI 1164782066
  NPD Authorized official
• Sharon Szeszycki

  • Dentist
  • Lombard, IL
  • NPI 1881808236
  NPD (past)

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1285232827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 S PARK BLVD STE 190",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601376282",
            "telephone_number": "630-469-0800",
            "fax_number": "630-474-0597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 S PARK BLVD STE 190",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601376282",
            "telephone_number": "630-469-0800",
            "fax_number": "630-474-0597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL DOODES DDS PHD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-15",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A",
        "authorized_official_last_name": "DOODES",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-765-1709",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS PHD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Blvd Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hetal Patel
• Leena T Patel, M.D.
• Mihir Navinchandra Patel
• Jennifer K Paterakis, M.S L.C.P.C
• Pathway Therapy Services PLLC
• Miriam Paull-Binette, LCSW
• Kelli Marie Paulus, HBCE, PES
• Peak Surgical Assistant Inc
• Patrick Allen Pecora, D.D.S.
• Penny Drop Therapy, Inc

• Dental Clinic/Center in Glen Ellyn, IL
• Providers in Glen Ellyn, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.