Suburban Family Dental

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

019016834 Issued in IL

Legal business name

SUBURBAN FAMILY DENTAL

Practice address

645 W Golf Rd
Des Plaines, IL 60016-2462

Phone

(847) 640-0778

Fax

(847) 640-2599

NPI assigned

Apr 8, 2009

Last updated

Apr 8, 2009By 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

Mary Miller

Title

Office Manager

Phone

(847) 640-0778

Specialties & licenses 4

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Roman M Dziubyk, D.D.S.

  • General Practice Dentistry
  • Des Plaines, IL
  • NPI 1528076015
  NPD (past)
• Lorelei Lynne Grise', D.D.S.

  • Periodontics
  • Antioch, IL
  • NPI 1003939992
  NPD (past)
• Marc A Miller, D.D.S.

  • General Practice Dentistry
  • Des Plaines, IL
  • NPI 1194749127
  NPD (past)

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

{
    "created_epoch": "1239148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239148800000",
    "number": "1295978104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 WEST GOLF ROAD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "60016",
            "telephone_number": "847-640-0778",
            "fax_number": "847-640-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 W GOLF RD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162462",
            "telephone_number": "847-640-0778",
            "fax_number": "847-640-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-08",
        "last_updated": "2009-04-08",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "847-640-0778"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019022514",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019016362",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "019022485",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019016834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Su Salud Physician Partners SC
• Mani N Subramanian, M.D.
• Susila Subramanian, M.D.
• Suburban Eye Consultants S.C. (The Midwest Center for Sight)
• Suburban Eye Consultants S.C. (The Midwest Center for Sight)
• Suburban Medical Center, S.C
• Suburban Orthotics & Prosthetics, Inc.
• Etan P Sugarman, M.D.
• Suh Chiropractic & Well-Being Clinic
• Karen Suleiman

• Oral and Maxillofacial Surgery (Dentist) in Des Plaines, IL
• Providers in Des Plaines, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.