Organization Active NPI

Sandwich Dentistry LLC

  • Dental Clinic/Center
  • Sandwich, IL
National Provider Identifier
1427874593
Registry record updated Dec 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SANDWICH DENTISTRY LLC
Practice address
1 E County Line Rd Ste a
Sandwich, IL 60548-9574
Phone
(832) 766-0144
NPI assigned
Nov 22, 2024
Last updated
Dec 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2024

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

Authorized official

Name
Dr. Rohan Vikram Shah, DDSNPI 1558815738
Title
Partner
Phone
(832) 766-0144

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 NU Primary

Addresses

Primary practice location

1 E County Line Rd Ste a
Sandwich, IL 60548-9574

Mailing address

10735 Clocktower Dr, Unit 303
Unit 303
Countryside, IL 60525
Phone (832) 766-0144

National Provider Directory

National Provider Directory

Locations

1 E County Line Rd
Ste A
Sandwich, IL 60548
Phone (815) 786-2185

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": "1732233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733529600000",
    "number": "1427874593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10735 CLOCKTOWER DR, UNIT 303",
            "address_2": "UNIT 303",
            "city": "COUNTRYSIDE",
            "state": "IL",
            "postal_code": "60525",
            "telephone_number": "832-766-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E COUNTY LINE RD STE A",
            "city": "SANDWICH",
            "state": "IL",
            "postal_code": "605489574",
            "telephone_number": "832-766-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDWICH DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-22",
        "last_updated": "2024-12-07",
        "certification_date": "2024-12-07",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "ROHAN",
        "authorized_official_middle_name": "VIKRAM",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "832-766-0144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandwich, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2024; 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.