Organization Active NPI

Morton Grove Dental Associates

  • General Practice Dentistry
  • Morton Grove, IL
National Provider Identifier
1467623231
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MORTON GROVE DENTAL ASSOCIATES
Practice address
9133 Waukegan Rd
Morton Grove, IL 60053-2120
Phone
(847) 470-0001
Fax
(847) 470-0132
NPI assigned
Mar 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2008

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

Authorized official

Name
Shari Bertini
Title
Office Manager
Phone
(847) 470-0001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X IL Primary

Addresses

Primary practice location

9133 Waukegan Rd
Morton Grove, IL 60053-2120

Mailing address

9133 Waukegan Rd
Morton Grove, IL 60053-2120
Phone (847) 470-0001

National Provider Directory

National Provider Directory

Locations

9133 Waukegan Rd
Morton Grove, IL 60053
Phone (847) 470-0001

Practitioners & affiliated clinicians

Practitioners 3

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": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205884800000",
    "number": "1467623231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9133 WAUKEGAN RD",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600532120",
            "telephone_number": "847-470-0001",
            "fax_number": "847-470-0132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9133 WAUKEGAN RD",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600532120",
            "telephone_number": "847-470-0001",
            "fax_number": "847-470-0132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORTON GROVE DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2008-03-19",
        "status": "A",
        "authorized_official_last_name": "BERTINI",
        "authorized_official_first_name": "SHARI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "847-470-0001"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; 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.