NPIMap

Organization Active NPI

Children'S Dentistry Group, LLC

  • Pediatric Dentistry
  • Lake Zurich, IL
National Provider Identifier
1497983688
Registry record updated Jun 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
019014868 Issued in IL
Legal business name
CHILDREN'S DENTISTRY GROUP, LLC
Practice address
195 S Rand Rd
Suite 110
Lake Zurich, IL 60047-2205
Phone
(847) 726-0300
Fax
(847) 726-3799
NPI assigned
Jun 25, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2009

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

Authorized official

Name
Dr. Paul Dana Herer, D.M.D., M.S.NPI 1689745457
Title
Owner
Phone
(847) 726-0300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 019014868 IL Primary

Addresses

Primary practice location

195 S Rand Rd
Suite 110
Lake Zurich, IL 60047-2205

Mailing address

195 S Rand Rd
Suite 110
Lake Zurich, IL 60047-2205
Phone (847) 726-0300

National Provider Directory

National Provider Directory

Locations

195 S Rand Rd
Ste 110
Lake Zurich, IL 60047
Phone (847) 726-0300

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245888000000",
    "number": "1497983688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 S RAND RD",
            "address_2": "SUITE 110",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600472205",
            "telephone_number": "847-726-0300",
            "fax_number": "847-726-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 S RAND RD",
            "address_2": "SUITE 110",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600472205",
            "telephone_number": "847-726-0300",
            "fax_number": "847-726-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S DENTISTRY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-25",
        "last_updated": "2009-06-25",
        "status": "A",
        "authorized_official_last_name": "HERER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "DANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-726-0300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D., M.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "019014868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Zurich, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.