Valley Creek Family Dental LTD

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

019029811 Issued in IL

Legal business name

VALLEY CREEK FAMILY DENTAL LTD

Practice address

16653 80TH Ave
Tinley Park, IL 60477

Phone

(708) 429-9699

NPI assigned

Jul 26, 2017

Organization subpart

No

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

Authorized official

Name

Patrick Michael Mitsos, DMD

Title

President

Phone

(708) 429-9699

Specialties & licenses 1

Addresses

Tax ID family

Valley Creek Family Dental LTD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Valley Creek Family Dental LTD

  • Dental Clinic/Center
  • Mokena, IL
  • NPI 1215450408
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chris Bernard Gambla, D.D.S.

  • General Practice Dentistry
  • Tinley Park, IL
  • NPI 1720104854
  NPD (past)

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

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503532800000",
    "number": "1386168953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16653 80TH AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771215",
            "telephone_number": "708-429-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16653 80TH AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "60477",
            "telephone_number": "708-429-9699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY CREEK FAMILY DENTAL LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-26",
        "last_updated": "2017-08-24",
        "status": "A",
        "authorized_official_last_name": "MITSOS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-429-9699",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019029811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennie Valdez, RBT
• James Paul Valek, M.D.
• Melissa Valencia
• Valentino Counseling LLC
• Danielle Lynn Valentino, MA, LCPC, CADC, CNA
• Kimberly D Van Wyngarden, APRN-BC
• Khai Van, OD
• Vandenberg Med-Tech Equipment, Inc.
• Dawn Marie Vandermeer, FNP
• Monica Vandervoort, PT

• Dental Clinic/Center in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2017; 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.