NPIMap

Organization Active NPI

The Dental Store, LTD.

  • General Practice Dentistry
  • Des Plaines, IL
National Provider Identifier
1336013242
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
THE DENTAL STORE, LTD.
Practice address
1455 E Golf Rd Ste 118
Des Plaines, IL 60016-1253
Phone
(847) 824-5044
NPI assigned
Oct 2, 2025
Organization subpart
Yes
Parent organization
THE DENTAL STORE, LTD.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Authorized official

Name
Jason Brenner, DDS
Title
President
Phone
(347) 415-4944

Specialties & licenses 1

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

Addresses

Primary practice location

1455 E Golf Rd Ste 118
Des Plaines, IL 60016-1253

Mailing address

1061 S Roselle Rd
Schaumburg, IL 60193-3900
Phone (847) 301-0400

National Provider Directory

National Provider Directory
Tax ID family
The Dental Store LTD3 organizations share this tax ID, including this one
Part of
The Dental Store LTD

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1455 E Golf Rd
Ste 118
Des Plaines, IL 60016
Phone (847) 824-5044

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1759363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759363200000",
    "number": "1336013242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 S ROSELLE RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601933900",
            "telephone_number": "847-301-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 E GOLF RD STE 118",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161253",
            "telephone_number": "847-824-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DENTAL STORE, LTD.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE DENTAL STORE, LTD.",
        "enumeration_date": "2025-10-02",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A",
        "authorized_official_last_name": "BRENNER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-415-4944",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; 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.