M & R Dental, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

M & R DENTAL, PLLC

Practice address

1560 Sherman Ave Ste 902
Evanston, IL 60201-4809

Phone

(847) 864-8151

NPI assigned

Aug 25, 2022

Organization subpart

No

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

Authorized official

Name

Ms. Coleen-Shannon Licar

Title

Manager

Phone

(847) 864-8151

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Marcos Antonio Montoya, D.D.S.

  • Dentist
  • Evanston, IL
  • NPI 1285996504
  NPD
• Rares Raibulet

  • General Practice Dentistry
  • Evanston, IL
  • NPI 1174972202
  NPD
• Lucas Stephens, DMD

  • General Practice Dentistry
  • Tustin, CA
  • NPI 1063965986
  NPD (past)

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661385600000",
    "number": "1558080283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 SHERMAN AVE STE 902",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014809",
            "telephone_number": "847-864-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 SHERMAN AVE STE 902",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014809",
            "telephone_number": "847-864-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M & R DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-25",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A",
        "authorized_official_last_name": "LICAR",
        "authorized_official_first_name": "COLEEN-SHANNON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-864-8151",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan Lynch
• Lynne M. Simon Professional Corporation
• Lynnshymanlcsw,LLC
• Stephanie Lyons, LCSW
• David Allen Lyubashevsky, MD
• M Lichterman PLLC
• Angela Maas, PHARMD
• Deborah Mabin, LCPC
• Christopher-Armand Zaragoza Mabini, DO
• Caitlin Macgregor, MD

• General Practice Dentistry in Evanston, IL
• Providers in Evanston, 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 Aug 25, 2022; 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.