NPIMap

Organization Active NPI

Dental Professionals of Illinois, P.C.

Doing business as Family Dental of Orland Park

  • General Practice Dentistry
  • Orland Park, IL
National Provider Identifier
1356539225
Registry record updated Jan 7, 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
Family Dental of Orland Park
Practice address
11041 W 179TH St
Orland Park, IL 60467-9452
Phone
(708) 478-5093
Fax
(708) 478-5096
NPI assigned
Oct 4, 2007
Last updated
Jan 7, 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 Jan 7, 2014

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

Authorized official

Name
Lindsay Bearden
Title
Ins Coord
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

11041 W 179TH St
Orland Park, IL 60467-9452

Mailing address

11041 W 179TH St
Orland Park, IL 60467-9452
Phone (708) 478-5093

Other names 1

  • Family Dental of Orland Park Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of Illinois PC75 organizations share this tax ID, including this one
Part of
Dental Professionals 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

11041 W 179th St
Orland Park, IL 60467
Phone (708) 478-5093

Practitioners & affiliated clinicians

Practitioners 2

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": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389052800000",
    "number": "1356539225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11041 W 179TH ST",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604679452",
            "telephone_number": "708-478-5093",
            "fax_number": "708-478-5096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11041 W 179TH ST",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604679452",
            "telephone_number": "708-478-5093",
            "fax_number": "708-478-5096"
        }
    ],
    "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": "2007-10-04",
        "last_updated": "2014-01-07",
        "status": "A",
        "authorized_official_last_name": "BEARDEN",
        "authorized_official_first_name": "LINDSAY",
        "authorized_official_title_or_position": "INS COORD",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Dental of Orland Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.