NPIMap

Organization Active NPI

Dental Professionals of Illinois, P.C.

Doing business as Oswego Commons Family Dental

  • General Practice Dentistry
  • Oswego, IL
National Provider Identifier
1346651577
Registry record updated May 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Doing business as
Oswego Commons Family Dental
Practice address
1490 Douglas Rd
Oswego, IL 60543-5106
Phone
(331) 725-7669
NPI assigned
May 9, 2014
Last updated
May 9, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 9, 2014

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

Authorized official

Name
Lindsayl Bearden
Title
Credentialing Coordinator
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

1490 Douglas Rd
Oswego, IL 60543-5106

Mailing address

1490 Douglas Rd
Oswego, IL 60543-5106
Phone (331) 725-7669

Other names 1

  • Oswego Commons Family Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Family Dental Care of Illinois PC75 organizations share this tax ID, including this one
Part of
Heartland Family Dental Care of Illinois PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1490 Douglas Rd
Oswego, IL 60543
Phone (331) 725-7669

NPI Registry JSON

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

{
    "created_epoch": "1399593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399593600000",
    "number": "1346651577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 DOUGLAS RD",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605435106",
            "telephone_number": "331-725-7669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 DOUGLAS RD",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605435106",
            "telephone_number": "331-725-7669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF ILLINOIS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF ILLINOIS, P.C.",
        "enumeration_date": "2014-05-09",
        "last_updated": "2014-05-09",
        "status": "A",
        "authorized_official_last_name": "BEARDEN",
        "authorized_official_first_name": "LINDSAYL",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oswego Commons Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oswego, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2014; 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.