NPIMap

Organization Active NPI

CCB Dental Associates PC

  • Dentist
  • Joliet, IL
National Provider Identifier
1376605428
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
CCB DENTAL ASSOCIATES PC
Practice address
1118 N Larkin Avenue
Joliet, IL 60435
Phone
(815) 729-0661
Fax
(815) 729-1617
NPI assigned
Dec 15, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ginger Ann Christian, DDSNPI 1942450275
Title
President
Phone
(815) 729-0661

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X IL
Dentist 122300000X IL
Dentist 122300000X IL Primary

Addresses

Primary practice location

1118 N Larkin Avenue
Joliet, IL 60435

Mailing address

1118 N Larkin Avenue
Joliet, IL 60435
Phone (815) 729-0661

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376605428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 N LARKIN AVENUE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "60435",
            "telephone_number": "815-729-0661",
            "fax_number": "815-729-1617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 N LARKIN AVENUE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "60435",
            "telephone_number": "815-729-0661",
            "fax_number": "815-729-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCB DENTAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHRISTIAN",
        "authorized_official_first_name": "GINGER",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-729-0661",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.