Organization Active NPI

Thornwood Family Dental

  • Dentist
  • South Elgin, IL
National Provider Identifier
1457721185
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
THORNWOOD FAMILY DENTAL
Practice address
1900 Silver Glen Rd
South Elgin, IL 60177-3316
Phone
(847) 888-1999
NPI assigned
Oct 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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

Authorized official

Name
Mrs. Joy K Gustafson
Title
Manager
Phone
(815) 871-2960

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1900 Silver Glen Rd
South Elgin, IL 60177-3316

Mailing address

1900 Silver Glen Rd
South Elgin, IL 60177-3316
Phone (847) 888-1999

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444176000000",
    "number": "1457721185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER GLEN RD",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601773316",
            "telephone_number": "847-888-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SILVER GLEN RD",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601773316",
            "telephone_number": "847-888-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THORNWOOD FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A",
        "authorized_official_last_name": "GUSTAFSON",
        "authorized_official_first_name": "JOY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "815-871-2960",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Elgin, IL

Sources for this page

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