NPIMap

Organization Active NPI

Glenbrook Oral & Maxillofacial Surgery LTD

  • Oral and Maxillofacial Surgery (Dentist)
  • Glenview, IL
National Provider Identifier
1306048780
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
060-005529 Issued in IL
Legal business name
GLENBROOK ORAL & MAXILLOFACIAL SURGERY LTD
Practice address
3633 W Lake Ave
Suite 100
Glenview, IL 60026-5805
Phone
(847) 998-8959
Fax
(847) 998-8791
NPI assigned
Jun 5, 2007
Last updated
Nov 16, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2012

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

Authorized official

Name
Dr. Jeffery K Bressman, DDSNPI 1154345106
Title
President
Phone
(847) 998-8959

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 060-005529 IL Primary

Addresses

Primary practice location

3633 W Lake Ave
Suite 100
Glenview, IL 60026-5805

Mailing address

3633 W Lake Ave
Suite 100
Glenview, IL 60026-5805
Phone (847) 998-8959

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353024000000",
    "number": "1306048780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 W LAKE AVE",
            "address_2": "SUITE 100",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265805",
            "telephone_number": "847-998-8959",
            "fax_number": "847-998-8791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 W LAKE AVE",
            "address_2": "SUITE 100",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265805",
            "telephone_number": "847-998-8959",
            "fax_number": "847-998-8791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENBROOK ORAL & MAXILLOFACIAL SURGERY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2012-11-16",
        "status": "A",
        "authorized_official_last_name": "BRESSMAN",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-998-8959",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "060-005529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; 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.