Ravenswood Dental Group

Primary specialty

DentistTaxonomy code 122300000X

License

019019228 Issued in IL

Legal business name

RAVENSWOOD DENTAL GROUP

Practice address

5015 N Paulina St
Suite 330
Chicago, IL 60640-2756

Phone

(773) 334-3555

Fax

(773) 334-5771

NPI assigned

Sep 3, 2008

Last updated

Sep 3, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Henry Lotsof, DDSNPI 1861576498

Title

President

Phone

(773) 334-3555

Specialties & licenses 1

Addresses

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.

• Henry Louis Lotsof, DDS

  • Dentist
  • Chicago, IL
  • NPI 1861576498
  NPD (past) Authorized official

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220400000000",
    "number": "1528216538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5015 N PAULINA ST",
            "address_2": "SUITE 330",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402756",
            "telephone_number": "773-334-3555",
            "fax_number": "773-334-5771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 N PAULINA ST",
            "address_2": "SUITE 330",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402756",
            "telephone_number": "773-334-3555",
            "fax_number": "773-334-5771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVENSWOOD DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-03",
        "last_updated": "2008-09-03",
        "status": "A",
        "authorized_official_last_name": "LOTSOF",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-334-3555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019019228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy M. Raven, M.A.
• Ravenco Inc
• Paul Anthony Ravenna, M.D.
• Ravenswood Counseling Center
• Ravenswood Counseling Center Co
• Ravenswood Dental PLLC
• Ravenswood Family Practice
• Ravenswood Health and Wellness Center, S.C.
• Ravenswood Health Center, P.C.
• Ravenswood Pediatrics SC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; 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.