Grand Dentistry Loop, LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

GRAND DENTISTRY LOOP, LLC

Practice address

120 W Madison St Lowr Level
Chicago, IL 60602-4103

Phone

(312) 955-9020

NPI assigned

Sep 28, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Eric A McLean, DMD

Title

Dentist/Co-Owner

Phone

(815) 260-3729

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1538092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538092800000",
    "number": "1588149264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W MADISON ST LOWR LEVEL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606024103",
            "telephone_number": "312-955-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W MADISON ST LOWR LEVEL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606024103",
            "telephone_number": "312-955-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND DENTISTRY LOOP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-28",
        "last_updated": "2018-09-28",
        "status": "A",
        "authorized_official_last_name": "MCLEAN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTIST/CO-OWNER",
        "authorized_official_telephone_number": "815-260-3729",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Grand Medical Clinic, Inc
• Grand Michigan Dentistry, PC
• Grand Pharmacy LLC

• 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 28, 2018; 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.