NPIMap

Organization Active NPI

Oak Ridge Family Dental LLC

  • Dentist
  • Oak Lawn, IL
National Provider Identifier
1407084445
Registry record updated Jun 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019-018909 Issued in IL
Legal business name
OAK RIDGE FAMILY DENTAL LLC
Practice address
4445 W 95TH St
Oak Lawn, IL 60453-7219
Phone
(708) 422-2224
Fax
(708) 422-0296
NPI assigned
Jun 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2009

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

Authorized official

Name
Dr. Victoria A Pavletic-Vorderer, D.D.S.
Title
Dentist
Phone
(708) 422-2224

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019-018909 IL Primary

Addresses

Primary practice location

4445 W 95TH St
Oak Lawn, IL 60453-7219

Mailing address

4445 W 95TH St
Oak Lawn, IL 60453-7219
Phone (708) 422-2224

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246233600000",
    "number": "1407084445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604537219",
            "telephone_number": "708-422-2224",
            "fax_number": "708-422-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604537219",
            "telephone_number": "708-422-2224",
            "fax_number": "708-422-0296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK RIDGE FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-29",
        "last_updated": "2009-06-29",
        "status": "A",
        "authorized_official_last_name": "PAVLETIC-VORDERER",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "708-422-2224",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-018909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.