LRC Periodontics and Implants, LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

019.027682 Issued in IL

Legal business name

LRC PERIODONTICS AND IMPLANTS, LLC

Practice address

1099 Belt Line Rd
Suite a
Collinsville, IL 62234-4380

Phone

(402) 943-7711

NPI assigned

Oct 19, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Laura Richards Capati, DMD, MS

Title

Owner/Periodontist

Phone

(402) 943-7711

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350604800000",
    "number": "1386997906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 BELT LINE RD",
            "address_2": "SUITE A",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622344380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 BELT LINE RD",
            "address_2": "SUITE A",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622344380",
            "telephone_number": "402-943-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LRC PERIODONTICS AND IMPLANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-19",
        "last_updated": "2012-10-19",
        "status": "A",
        "authorized_official_last_name": "CAPATI",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "RICHARDS",
        "authorized_official_title_or_position": "OWNER/PERIODONTIST",
        "authorized_official_telephone_number": "402-943-7711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "019.027682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelley Laverne Lee, LCPC
• Shayne N Lewis, MOT
• Heather D Like
• Mafeth Araula Lim, DO
• Linda N. Summers, PSYD., PLLC
• Carol A Lucas
• Maria Nicole Luebbers, OTR
• Kassandra Mapel, PT
• Juliann E Marth, DPT
• Jacqueline Martinez, MHP

• Periodontics in Collinsville, IL
• Providers in Collinsville, IL by specialty
• Periodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; 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.