NPIMap

Organization Active NPI

Lake Cook Dental Center

  • Customized Equipment (DME)
  • Itasca, IL
National Provider Identifier
1487992327
Registry record updated Jan 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
License
019025184 Issued in IL
Legal business name
LAKE COOK DENTAL CENTER
Practice address
115 W Orchard St
Itasca, IL 60143-1700
Phone
(847) 250-5580
NPI assigned
Jan 28, 2013
Last updated
Jan 28, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2013

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

Authorized official

Name
Dr. Rose M Lesniak, DDS
Title
President
Phone
(847) 250-5580

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X 019025184 IL Primary

Addresses

Primary practice location

115 W Orchard St
Itasca, IL 60143-1700

Mailing address

115 W Orchard St
Itasca, IL 60143-1700
Phone (847) 250-5580

National Provider Directory

National Provider Directory
Tax ID family
Lake Cook Dental Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

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": "1359331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359331200000",
    "number": "1487992327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W ORCHARD ST",
            "city": "ITASCA",
            "state": "IL",
            "postal_code": "601431700",
            "telephone_number": "847-250-5580",
            "fax_number": "847-250-5581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W ORCHARD ST",
            "city": "ITASCA",
            "state": "IL",
            "postal_code": "601431700",
            "telephone_number": "847-250-5580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE COOK DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-28",
        "last_updated": "2013-01-28",
        "status": "A",
        "authorized_official_last_name": "LESNIAK",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-250-5580",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "IL",
            "license": "019025184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Itasca, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; 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.