NPIMap

Organization Active NPI

Pro Dental Care LTD

  • General Practice Dentistry
  • Elgin, IL
National Provider Identifier
1306055058
Registry record updated May 11, 2017
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019021499 Issued in IL
Legal business name
PRO DENTAL CARE LTD
Practice address
300 S Randall Rd
Elgin, IL 60123-5525
Phone
(630) 883-0200
NPI assigned
May 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Authorized official

Name
Mr. Rick S Brar, D.M.D
Title
President/Owner
Phone
(630) 883-0200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 019021499 IL Primary

Addresses

Primary practice location

300 S Randall Rd
Elgin, IL 60123-5525

Mailing address

300 S Randall Rd
Elgin, IL 60123-5525
Phone (630) 883-0200

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1306055058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S RANDALL RD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601235525",
            "telephone_number": "630-883-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S RANDALL RD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601235525",
            "telephone_number": "630-883-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO DENTAL CARE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "BRAR",
        "authorized_official_first_name": "RICK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "630-883-0200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019021499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.