NPIMap

Organization Active NPI

Robert T. Lesage

  • General Practice Dentistry
  • Dixon, IL
National Provider Identifier
1528085271
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19A13394 Issued in IL
Legal business name
ROBERT T. LESAGE
Practice address
815 N Galena Ave
Dixon, IL 61021-1518
Phone
(815) 288-1418
NPI assigned
Jul 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Authorized official

Name
Dr. Robert Thomas Lesage, DDSNPI 1831463355
Title
Dentist
Phone
(815) 288-1418

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 19A13394 IL Primary

Addresses

Primary practice location

815 N Galena Ave
Dixon, IL 61021-1518

Mailing address

815 N Galena Ave
Dixon, IL 61021-1518

Other names 1

  • lesage dental clinic ltd Other name

National Provider Directory

National Provider Directory

Locations

815 N Galena Ave
Dixon, IL 61021
Phone (815) 288-1418

Practitioners & affiliated clinicians

Practitioners 1

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": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350864000000",
    "number": "1528085271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 N GALENA AVE",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610211518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 N GALENA AVE",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610211518",
            "telephone_number": "815-288-1418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT T. LESAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2012-10-22",
        "status": "A",
        "authorized_official_last_name": "LESAGE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "815-288-1418",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19A13394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "lesage dental clinic ltd",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dixon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.