NPIMap

Organization Active NPI

North Suburban Oral and Maxillofacial Surgery LTD

  • Oral and Maxillofacial Pathology Dentistry
  • Lake Forest, IL
National Provider Identifier
1477664332
Registry record updated Feb 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
021000537 Issued in IL
Legal business name
NORTH SUBURBAN ORAL AND MAXILLOFACIAL SURGERY LTD
Practice address
900 N Westmoreland Rd
Suite 208
Lake Forest, IL 60045-1674
Phone
(847) 234-3390
Fax
(847) 234-3391
NPI assigned
Aug 31, 2006
Last updated
Feb 10, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2009

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

Authorized official

Name
Dr. Richard P. Martino, DDSNPI 1487694097
Title
President
Phone
(847) 234-3390

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 021000537 IL Primary

Addresses

Primary practice location

900 N Westmoreland Rd
Suite 208
Lake Forest, IL 60045-1674

Mailing address

900 N Westmoreland Rd
Suite 208
Lake Forest, IL 60045-1674
Phone (847) 234-3390

National Provider Directory

National Provider Directory

Locations

900 N Westmoreland Rd
Ste 208
Lake Forest, IL 60045
Phone (847) 234-3390

Practitioners & affiliated clinicians

Practitioners 2

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234224000000",
    "number": "1477664332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N WESTMORELAND RD",
            "address_2": "SUITE 208",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451674",
            "telephone_number": "847-234-3390",
            "fax_number": "847-234-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N WESTMORELAND RD",
            "address_2": "SUITE 208",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451674",
            "telephone_number": "847-234-3390",
            "fax_number": "847-234-3391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SUBURBAN ORAL AND MAXILLOFACIAL SURGERY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-02-10",
        "status": "A",
        "authorized_official_last_name": "MARTINO",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-234-3390",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "IL",
            "license": "021000537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2009; 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.