City Kids Dental North Shore, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

019025964 Issued in IL

Legal business name

CITY KIDS DENTAL NORTH SHORE, LLC

Practice address

585 Lincoln Ave
Suite 2
Winnetka, IL 60093-2351

Phone

(847) 446-0950

Fax

(847) 446-0985

NPI assigned

Mar 5, 2009

Last updated

Aug 16, 2012By 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. A. Melissa Lopez, DMD, MPH

Title

Co-Owner

Phone

(847) 446-0950

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1236211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345075200000",
    "number": "1629218557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 LINCOLN AVE",
            "address_2": "SUITE 2",
            "city": "WINNETKA",
            "state": "IL",
            "postal_code": "600932351",
            "telephone_number": "847-446-0950",
            "fax_number": "847-446-0985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 LINCOLN AVE",
            "address_2": "SUITE 2",
            "city": "WINNETKA",
            "state": "IL",
            "postal_code": "600932351",
            "telephone_number": "847-446-0950",
            "fax_number": "847-446-0985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY KIDS DENTAL NORTH SHORE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-05",
        "last_updated": "2012-08-16",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "A. MELISSA",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "847-446-0950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MPH"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "019025964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie V Cavanaugh, MD
• Katherine M Ceisel, PT
• Leigh Ann Charlot, LCSW
• Chiropractic Without Limits LLC (Winnetka Family Chiropractic)
• Kathleen Christell, PT,DPT
• Claire Kenneally, LTD
• David Charles Clark, PH.D.
• Susan H Clark, MD
• Douglas G Cleary, MD
• Collective Physical Therapy, PLLC

• Pediatric Dentistry in Winnetka, IL
• Providers in Winnetka, IL by specialty
• Pediatric Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; 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.