Orchard Crossing Family Dentistry

Primary specialty

DentistTaxonomy code 122300000X

License

019026445 Issued in IL

Legal business name

ORCHARD CROSSING FAMILY DENTISTRY

Practice address

2080 Orchard Rd
Montgomery, IL 60538-1059

Phone

(630) 859-3550

NPI assigned

Dec 23, 2009

Organization subpart

No

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

Authorized official

Name

John P Gaspard

Title

Owner/Doctor

Phone

(630) 859-3550

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1261526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261526400000",
    "number": "1356670202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 ORCHARD RD",
            "city": "MONTGOMERY",
            "state": "IL",
            "postal_code": "605381059",
            "telephone_number": "630-859-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 ORCHARD RD",
            "city": "MONTGOMERY",
            "state": "IL",
            "postal_code": "605381059",
            "telephone_number": "630-859-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORCHARD CROSSING FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-23",
        "last_updated": "2009-12-23",
        "status": "A",
        "authorized_official_last_name": "GASPARD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "630-859-3550"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019026445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Montgomery, IL
• Providers in Montgomery, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2009; 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.