NPIMap

Organization Active NPI

Primary Dental LTD

  • Dentist
  • Hanover Park, IL
National Provider Identifier
1538480900
Registry record updated Jun 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019-026875 Issued in IL
Legal business name
PRIMARY DENTAL LTD
Practice address
1814 Irving Park Rd
Hanover Park, IL 60133-3254
Phone
(630) 660-3233
NPI assigned
Jun 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2010

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

Authorized official

Name
Dr. Kavita ShahNPI 1811000813
Title
President
Phone
(630) 660-3233

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019-026875 IL Primary

Addresses

Primary practice location

1814 Irving Park Rd
Hanover Park, IL 60133-3254

Mailing address

1256 Lakewood Cir
Naperville, IL 60540-0996
Phone (630) 660-3233

National Provider Directory

National Provider Directory

Locations

1814 Irving Park Rd
Hanover Park, IL 60133
Phone (630) 660-3233

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": "1276819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276819200000",
    "number": "1538480900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1256 LAKEWOOD CIR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605400996",
            "telephone_number": "630-660-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 IRVING PARK RD",
            "city": "HANOVER PARK",
            "state": "IL",
            "postal_code": "601333254",
            "telephone_number": "630-660-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY DENTAL LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-18",
        "last_updated": "2010-06-18",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "KAVITA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-660-3233",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-026875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2010; 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.