McLean Dental Clinic, P.C.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

019022632 Issued in IL

Legal business name

MCLEAN DENTAL CLINIC, P.C.

Practice address

400 N Division St
Harvard, IL 60033-3061

Phone

(815) 943-7709

Fax

(815) 943-2009

NPI assigned

May 4, 2015

Organization subpart

Yes

Parent organization

MCLEAN DENTAL, P.C.As reported in NPPES

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

Authorized official

Name

Dr. Mumtaz Siddique

Title

Doctor

Phone

(815) 943-7709

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

McLean Dental Clinic PC2 organizations share this tax ID, including this one

Part of

McLean Dental Clinic PC

Other organizations with this tax ID 1

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

• McLean Dental Clinic, P.C.

  • Dental Clinic/Center
  • Elgin, IL
  • NPI 1295122539
  NPD tax ID

Locations

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430697600000",
    "number": "1427435056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N DIVISION ST",
            "city": "HARVARD",
            "state": "IL",
            "postal_code": "600333061",
            "telephone_number": "815-943-7709",
            "fax_number": "815-943-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N DIVISION ST",
            "city": "HARVARD",
            "state": "IL",
            "postal_code": "600333061",
            "telephone_number": "815-943-7709",
            "fax_number": "815-943-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLEAN DENTAL CLINIC, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCLEAN DENTAL, P.C.",
        "enumeration_date": "2015-05-04",
        "last_updated": "2015-05-04",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUE",
        "authorized_official_first_name": "MUMTAZ",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "815-943-7709",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019022632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019022632",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marengo Vision Center, P.C. (Harvard Family Eye Care)
• Heather Marlow IV
• Amanda Marshall, LMT
• Reba Martin
• Lisa Kiep Martinez, RPH
• McLean Foot Clinic,P.C. (Harvard Foot Clinic,P.C.)
• Mercy Assisted Care, Inc (Mercyhealth At Home)
• Mercy Harvard Hospital Inc (Mercy Harvard Care Center)
• Mercy Harvard Hospital Inc
• Mercy Health System Corporation (Mercy Harvard Hosptial Clinic)

• Dental Clinic/Center in Harvard, IL
• Providers in Harvard, 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 May 4, 2015; 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.