Lincoln Park Dental Care LTD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019025117 Issued in IL

Legal business name

LINCOLN PARK DENTAL CARE LTD

Practice address

424 W Fullerton Pkwy
Chicago, IL 60614-2812

Phone

(773) 404-0101

Fax

(773) 404-1260

NPI assigned

May 6, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Seong Ju Kim, DDS.NPI 1609906270

Title

General Dentist

Phone

(773) 404-0101

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Seong Ju Kim, DDS

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1609906270
  NPD (past) Authorized official
• Linh Thuy Tran, DMD

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1619968880
  NPD (past)

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1548436959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 W FULLERTON PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606142812",
            "telephone_number": "773-404-0101",
            "fax_number": "773-404-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 W FULLERTON PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606142812",
            "telephone_number": "773-404-0101",
            "fax_number": "773-404-1260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN PARK DENTAL CARE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-06",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SEONG",
        "authorized_official_middle_name": "JU",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "773-404-0101",
        "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": "019025117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lincoln Medical Center, PC
• Lincoln Park Cardiovascular and Thoracic Surgeons, SC
• Lincoln Park Center for Dental Anesthesia
• Lincoln Park Chiropractic, LLC
• Lincoln Park Chiropractic, PC
• Lincoln Park Dental Specialists
• Lincoln Park Dialysis Services Inc
• Lincoln Park Dialysis Services Inc
• Lincoln Park Dialysis Services Inc
• Lincoln Park Eyes LLC

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.