Elite Family Dental Center, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

019026746 Issued in IL

Legal business name

ELITE FAMILY DENTAL CENTER, LLC

Practice address

719 Barron Blvd
Grayslake, IL 60030-3314

Phone

(734) 709-1363

NPI assigned

Nov 15, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Louis Whitesman, DDS, MS

Title

President

Phone

(734) 709-1363

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384473600000",
    "number": "1497185276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 BARRON BLVD",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600303314",
            "telephone_number": "734-709-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 BARRON BLVD",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600303314",
            "telephone_number": "734-709-1363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE FAMILY DENTAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-15",
        "last_updated": "2013-11-15",
        "status": "A",
        "authorized_official_last_name": "WHITESMAN",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-709-1363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019026746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Grayslake, IL
• Providers in Grayslake, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.