Lake County Smile Doctors LTD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019023664 Issued in IL

Legal business name

LAKE COUNTY SMILE DOCTORS LTD

Practice address

740 Florsheim Dr
Suite 13
Libertyville, IL 60048-3712

Phone

(847) 816-3949

NPI assigned

Oct 6, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Brian Danielewicz, DDS

Title

Dentist

Phone

(847) 816-3949

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1381017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381017600000",
    "number": "1386071322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 FLORSHEIM DR",
            "address_2": "SUITE 13",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483712",
            "telephone_number": "847-816-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 FLORSHEIM DR",
            "address_2": "SUITE 13",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483712",
            "telephone_number": "847-816-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE COUNTY SMILE DOCTORS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-06",
        "last_updated": "2013-10-06",
        "status": "A",
        "authorized_official_last_name": "DANIELEWICZ",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "847-816-3949",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019023664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Libertyville, IL
• Providers in Libertyville, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2013; 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.