NPIMap

Organization Active NPI

Northshore Metropolitan Dental Associates, Inc

  • Durable Medical Equipment & Medical Supplies
  • Skokie, IL
National Provider Identifier
1427047349
Registry record updated Oct 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
NORTHSHORE METROPOLITAN DENTAL ASSOCIATES, INC
Practice address
4709 Golf Rd
Suite 804
Skokie, IL 60076-1231
Phone
(847) 673-6770
Fax
(847) 673-6778
NPI assigned
Oct 14, 2005
Last updated
Oct 2, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2019

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

Authorized official

Name
Dr. Victor Lau, D.D.S.NPI 1952381410
Title
President
Phone
(847) 673-6770

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019025154 IL
General Practice Dentistry 1223G0001X 019010896 IL
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

4709 Golf Rd
Suite 804
Skokie, IL 60076-1231

Mailing address

4709 Golf Rd
Suite 804
Skokie, IL 60076-1231
Phone (847) 673-6770

Other practice location 1

1790 Nations Dr Ste 212
Gurnee, IL 60031-9176
Phone (847) 336-4880

National Provider Directory

National Provider Directory

Locations

4709 Golf Rd
Ste 804
Skokie, IL 60076
Phone (847) 673-6770

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569974400000",
    "number": "1427047349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4709 GOLF RD",
            "address_2": "SUITE 804",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761231",
            "telephone_number": "847-673-6770",
            "fax_number": "847-673-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4709 GOLF RD",
            "address_2": "SUITE 804",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761231",
            "telephone_number": "847-673-6770",
            "fax_number": "847-673-6778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1790 Nations Dr Ste 212",
            "address_purpose": "LOCATION",
            "city": "Gurnee",
            "state": "IL",
            "postal_code": "600319176",
            "country_code": "US",
            "telephone_number": "847-336-4880",
            "fax_number": "847-336-4885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHSHORE METROPOLITAN DENTAL ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-14",
        "last_updated": "2019-10-02",
        "status": "A",
        "authorized_official_last_name": "LAU",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-673-6770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025154",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019010896",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; 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.