Brookside Dental Care, LTD.

Primary specialty

DentistTaxonomy code 122300000X

License

019021315 Issued in IL

Legal business name

BROOKSIDE DENTAL CARE, LTD.

Practice address

10175 W Lincoln Hwy
Frankfort, IL 60423-1274

Phone

(815) 469-8837

Fax

(815) 469-8837

NPI assigned

Nov 7, 2006

Last updated

Jan 27, 2009By 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. Craig A Spencer, DDSNPI 1427136860

Title

Owner

Phone

(815) 469-8837

Specialties & licenses 1

Addresses

Locations

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.

• Craig A Spencer, DDS

  • Dentist
  • Frankfort, IL
  • NPI 1427136860
  NPD (past) Authorized official

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233014400000",
    "number": "1598834251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10175 W LINCOLN HWY",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231274",
            "telephone_number": "815-469-8837",
            "fax_number": "815-469-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10175 W LINCOLN HWY",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231274",
            "telephone_number": "815-469-8837",
            "fax_number": "815-469-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSIDE DENTAL CARE, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2009-01-27",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-469-8837",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019021315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robyn Braun, RBT
• Erin Marie Bresnahan, OTR/L, MS
• Marsha L Broers, MA
• John Joseph Brolley
• Brookside Advanced Clinic for Pain,Inc.
• Brotschul Health Care, S.C. (Access Wellness Center)
• Daniel Jason Brotschul, D.C.
• Amy Suszko Brown, PSY.D.
• Emily Brown, BCBA
• Bruce W. Smit DPM LTD (Frankfort Foot and Ankle Clinic)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2009; 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.