NPIMap

Organization Active NPI

White Plains Dental

  • Dental Clinic/Center
  • Northbrook, IL
National Provider Identifier
1417470915
Registry record updated Jul 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
019029371 Issued in IL
Legal business name
WHITE PLAINS DENTAL
Practice address
3073 Dundee Rd
Northbrook, IL 60062-2401
Phone
(847) 496-0158
NPI assigned
Jul 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2017

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

Authorized official

Name
Dr. Sung Hong, DDSNPI 1558680835
Title
Dentist
Phone
(847) 496-0158

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 019029371 IL Primary

Addresses

Primary practice location

3073 Dundee Rd
Northbrook, IL 60062-2401

Mailing address

278 Spring Creek Cir
Schaumburg, IL 60173-2154
Phone (919) 824-9107

Other identifiers 1

IdentifierTypeStateIssuer
1558680835MedicaidNC

National Provider Directory

National Provider Directory

Locations

3073 Dundee Rd
Northbrook, IL 60062
Phone (847) 496-0158

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500336000000",
    "number": "1417470915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "278 SPRING CREEK CIR",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601732154",
            "telephone_number": "919-824-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3073 DUNDEE RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622401",
            "telephone_number": "847-496-0158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE PLAINS DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-18",
        "last_updated": "2017-07-18",
        "status": "A",
        "authorized_official_last_name": "HONG",
        "authorized_official_first_name": "SUNG",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "847-496-0158",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019029371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558680835",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.